Bullous Pemphigoid

What is Bullous Pemphigoid?

Bullous Pemphigoid is a rare chronic skin disease . It causes fluid filled blisters that are very large on areas of the skin that flex.  The fluid is clear but sometimes it may contain blood. The skin around the blisters can be red, or may appear to be normal.   The most common places are the upper thighs, armpits, and lower abdomen and sometimes sores may appear in the mouth. It happens commonly in those that are over the age of 60. Skin can be very itchy. Mucous membranes may become red and sore, usually rare.   If the disease is not treated, it can last for months or even years.  If a blister ruptures and becomes infected, one can get Sepsis,  which is life threatening. It is a result of the immune system attacking a thin layer of skin that is below the outer layer of skin.

There are many forms of Bullous Pemphigoid.  They include:

• infant form:  Blisters on the skin that frequent the palms, soles, and face.  About 60% of the cases will have generalised blisters. Blisters could also appear on the genitals.
• Nodular form:  This is a rare form with blisters on normal appearing or nodular lesions on skin. It resembles Prurigo nodularis.
• Generalised bullous form:  This is the most common form of Bullous Pemphigoid.  Tense bullae (multiple blisters) form on any part of the skin, mainly on parts that flex.
• Vesicular form:  This form is not as common as generalised. Small, tense blisters will form, usually on a urtical or erythematous base.
• Generalized Erythematous form- This is a rare form that resembles psoriasis, generalized atopic dermatitis, or other skin conditions.
• Acral form- Commonly effects the palms, face and soles, it is associated with vaccinations.
• Vegative form-  Not common, effects the groin, neck, and other infra-mammary areas.

Causes of Bullous Pemphigoid

Causes of Bullous Pemphigoid is not fully known. some medications include penicillin, furosemide, etanercept, and sulfasalazine might be the cause.  Radiation therapy can also be a cause, as can UV light therapy.

What if I have Bullous Pemphigoid?

If you suspect that you have Bullous Pemphigoid, you should see your doctor. If confirmed for Bullous Pemphigoid, your doctor will prescribe some medications for treatment. This might include corticosteroids. This could be in a pill form, such as prednisone, or a cream that you could apply to the effected area.  Immunosuppressants could also be prescribed ,which will inhibit the production of WBCs.  Anti-inflammatories may also be prescribed to use alone or in conjunction with other treatments.

if diagnosed with Bullous Pemphigoid ,avoid exposure of the sun. If you must be out in the sun, keep the area effected covered. Watch the foods that you eat as well, especially if you have blisters in your mouth. Hard, crunchy foods will only aggravate the symptoms more. Skin is fragile due to not only Bullous Pemphigoid, but also from corticosteroid cream, so avoid injuring the area.  Should you have a blister break, cover it with a dressing to avoid infection.

Bullous Pemphigoid can be fully treatable, and many manage just fine with it.  In many cases, treatment is needed for many years.  Flareups can occur, but if one follows the treatment plan by their doctor, a good outlook can be seen.