Bullous Pemphigoid

What is bullous pemphigoid (BP)?

This is a rare skin where blisters develop on areas that flex such as the lower abdomen, upper thighs, and armpits. It occurs when the immune system attacks a thin layer of tissue below the skin surface. The reason for this attack is still unknown.

What are the symptoms and causes of BP?

The development of large blisters that are not easily ruptured. When the blisters do rupture the fluid is typically clear but sometimes contain blood. the base of the lesions are reddish and are often found on the lower abdomen, upper thighs and arms. The areas that are affected are very itchy. The cause of this condition is still unknown since the immune response is due to the body malfunctioning. The body produces antibodies to the fibers that connect the outer layer of the skin to the adjacent dermis. The antibodies cause inflammation with produces the blisters and other symptoms.

What are the risk factors for BP?

Age greater than 60 is a very big risk factor. Medications such as penicillin, etanercept (Enbrel), sulfasalazine, and furosemide (Lasix) can contribute to the condition. Ultraviolet light therapy may trigger a flare up of BP as well.

How do we diagnose BP?

Simple skin biopsy that is sent to a dermatopathologist for analysis is the definitive way to diagnose BP.

What is the treatment used for bullous pemphigoid?

The first goal of treating BP is to heal the skin quickly to prevent bacterial infection. Corticosteroids (prednisone) is the most common treatment but long term use of these drugs can cause damage to other parts of the body. Immunosuppressants such as azathioprine, Cellcept can be used to help stop the body from attacking itself. This drug can be used in lieu of prednisone so that long term use is not necessary.

Things to avoid if you suffer from BP.

Avoiding injury to the skin so that you decrease the chances of developing an infection. Avoiding prolonged exposure of the skin to the sun will help to decrease inflammation to the already affected skin.

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