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Bullous pemphigoid

Medically reviewed by Drugs.com. Last updated on Sep 27, 2022.

Overview

Bullous pemphigoid (BUL-us PEM-fih-goid) is a rare skin condition that causes large, fluid-filled blisters. They develop on areas of skin that often flex — such as the lower abdomen, upper thighs or armpits. Bullous pemphigoid is most common in older adults.

Bullous pemphigoid occurs when your immune system attacks a thin layer of tissue below your outer layer of skin. The reason for this abnormal immune response is unknown, although it sometimes can be triggered by taking certain medications.

Bullous pemphigoid often goes away on its own in a few months, but may take as many as five years to resolve. Treatment usually helps heal the blisters and ease any itching. It may include corticosteroid medications, such as prednisone, and other drugs that suppress the immune system. Bullous pemphigoid can be life-threatening, especially for older people who are already in poor health.

Bullous pemphigoid

People with bullous pemphigoid may develop multiple blisters. When the blisters rupture, they leave a sore that typically heals without scarring.

Symptoms

The signs and symptoms of bullous pemphigoid may include:

When to see a doctor

See your doctor if you develop:

Causes

The blisters occur because of a malfunction in your immune system.

Your body's immune system normally produces antibodies to fight bacteria, viruses or other potentially harmful foreign substances. For reasons that are not clear, the body may develop an antibody to a particular tissue in your body.

In bullous pemphigoid, the immune system produces antibodies to the fibers that connect the outer layer of skin (epidermis) and the next layer of skin (dermis). These antibodies trigger inflammation that produces the blisters and itching of bullous pemphigoid.

Complications

Contributing factors

Bullous pemphigoid usually appears randomly with no clear factors contributing to the onset of disease. Some cases may be triggered by:

Risk factors

Bullous pemphigoid most commonly occurs in older adults, and the risk increases with age.

Diagnosis

To confirm the diagnosis, your doctor may order blood tests and take a small sample of the affected skin (skin biopsy) for laboratory testing.

Your doctor may refer you to a doctor who specializes in conditions of the skin (dermatologist) or eyes (ophthalmologist), depending on your signs and symptoms and the results of your lab tests.

Treatment

Treatment is focused on healing the skin and relieving itching, while minimizing adverse side effects of medications. Your doctor will likely prescribe one or a combination of the drugs:

Lifestyle and home remedies

If you have bullous pemphigoid, you can help take care of your condition with the following self-care strategies:

Preparing for an appointment

You may start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist). You may want to bring a friend or relative to your appointment. This person, in addition to offering support, can write down information from your doctor or other clinic staff during the visit.

What you can do

Before your appointment make a list of:

For bullous pemphigoid, some basic questions to ask your doctor include:

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be prepared to answer the following:

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