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Bullous pemphigoid

Definition

Bullous pemphigoid is a skin disorder characterized by large blisters.

Causes, incidence, and risk factors

The cause is not known, but may be related to immune system disorders, certain other diseases, or use of some medications.

Bullous pemphigoid usually occurs in elderly persons and is rare in young people. Symptoms come and go. In most patients, the condition goes away within 5 years.

Symptoms

Some people have no symptoms. Others may have mild redness, itching and irritation.

In severe cases, they are multiple blisters, called bullae. Blisters are usually located on the arms, legs, or middle of the body. About one-third of persons with bullous pemphigoid also develop blisters in the mouth. The blisters may break open and form ulcers or open sores.

Other symptoms may include:

Signs and tests

Tests that may be done to help diagnose this condition include:

Treatment

Powerful anti-inflammatory medicines called corticosteroids may be prescribed. Some corticosteroids are taken by mouth, while others require a shot (injection). In persons with early forms of the disease, corticosteroid creams may be used.

Your doctor may prescribe chemotherapy or medicines to help suppress the immune system.

Antibiotics in the tetracycline family may be useful in mild cases. Niacin (a B complex vitamin) is sometimes given along with tetracycline.

Expectations (prognosis)

Bullous pemphigoid usually responds well to treatment. Most patients stop taking medicine after several years. The disease sometimes returns after treatment is stopped.

Complications

Skin infection is the most common complication.

Calling your health care provider

Call your doctor for an appointment if you have:

  • Unexplained blisters on your skin
  • An itchy rash that continues despite home treatment

References

Bernard P, Borradori L. Pemphigoid group. In: Bolognia JL, Jorizzo JL, Schaffer JV, eds. Dermatology. 3rd ed. Philadelphia, Pa.: Elsevier Saunders; 2012:chap 30.

Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Philadelphia, Pa.: Elsevier Mosby; 2009:chap 16.


Review Date: 5/15/2013
Reviewed By: Kevin Berman, MD, PhD, Atlanta Center for Dermatologic Disease, Atlanta, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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