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Bullous Pemphigoid – Pictures, Symptoms, Causes, Treatment

Updated on November 4, 2013

Bullous pemphigoid is a rare skin disease that results in the formation of large blisters that are full of fluids. The blisters typically occur on the upper thighs, lower abdomen, armpits, or other areas of the skin that are prone to flexing. Bullous pemphigoidusually affects people who are more than 60 years old.

Bullous pemphigoid is caused due to an erroneous attack by the immune on a thin layer of tissue that occurs just below the outer skin layer. The exact cause of this anomalous immune system reaction is not known; however, it can occasionally get activated by the intake of certain medicines.

Bullous pemphigoid is generally treated with corticosteroids like prednisone and other medications that inhibit the immune system. The disease can be deadly, more so in older individuals who are already suffering from ill health.

Symptoms of bullous pemphigoid

Patients of bullous pemphigoid may exhibit the following signs and symptoms:

  • The key symptom of bullous pemphigoid is the formation of large, fluid-filled blisters across certain areas of the body. Such blisters do not break easily on touch. The fluids are mostly clear, but can sometimes contain minuscule amounts of blood. The skin surrounding the blisters may be normal or reddish.
  • The skin areas affected by blister appearance tend to be extremely itchy.
  • Most patients suffer from blister formation on the arms, upper thighs, groin, and lower abdomen. The blisters mostly appear along the skin folds or creases, like those occurring on the inside portion of joints.
  • Affected individuals may also suffer from sores or blisters in the mouth.
  • In rare cases, the mucous membranes present in the eyes may also get affected. This can result in soreness, discomfort, and redness.

Consulting a doctor:Individuals who experience blistering without any known or explicable causes, such as an allergic reaction or presence of certain skin anomalies, should seek medical attention for proper diagnosis and treatment.

Medical treatment is also needed when complications of bullous pemphigoid are noticed. The blisters can rupture and become infected with bacteria and other organisms. This can result in sepsis which is a potentially fatal infection of the entire body. Sepsis typically tends to affect the elderly who are suffering from failing health. Another complication is scarring that arises due to oral or ocular bullous pemphigoid.

Causes of bullous pemphigoid

Scientists and researchers are unaware about the precise cause of bullous pemphigoid. It is however known that the skin disorder occurs due to an immune system dysfunction.

The immune system produces specific antibodies to counter certain bacteria, viruses, and other pathogens. For reasons that are currently unknown, the immune system of patients with bullous pemphigoid produces antibodies that attacks a particular tissue in the body. This tissue is the basement membrane of the skin, i.e., a slim layer of fibrous tissue that connects the epidermis or the outer skin layer to the dermis, the inner or subsequent layer of skin.The antibodies activate inflammatory reactions which eventually leads to formation of blisters and itchiness associated with bullous pemphigoid.

Causative factors: Bullous pemphigoid generally occurs at random and there are no distinctive factors that contribute towards development of this skin condition. However, a minor percentage of patients may suffer from bullous pemphigoid that may be activated by some medical therapies, like:

  • Intake of prescription medications such as furosemide, sulfasalazine, etanercept, and penicillin may cause the disease.
  • UV light therapy as treatment for some skin diseases, as well as radiation therapy for treating different types of cancers may also trigger the onset of bullous pemphigoid.

Risk factors:Individuals older than 60 years are commonly affected by bullous pemphigoid. The risk increases with an increase in the age.

Treatment of bullous pemphigoid

Treatment of bullous pemphigoid is aimed at aiding the quick healing of affected skin areas and alleviation of itchiness. A combination of medications may be prescribed by the doctor to suppress the immune system actions that result in skin inflammation. Some of these drugs are listed below:

  • Corticosteroid pills and creams or ointments
  • Immunosuppressant drugs to suppress the excessive production of antibodies by the immune system
  • Different types of anti-inflammatory medications which can be used on its own or along with corticosteroid therapy.

The below listed self-care steps will also help in alleviation of bullous pemphigoid symptoms:

  • Avoid the consumption of chips, raw vegetables and fruits, and other crunchy or hard foods, as it can worsen the symptoms.
  • Do not stay out under the sun for long periods. Ensure that all the skin areas affected by bullous pemphigoid blisters and inflammation are adequately covered and protected when venturing outdoors.
  • Bullous pemphigoid can make the skin very delicate. Corticosteroid therapy also contributes to increased fragility of the skin. Hence, avoid all trauma or injury to skin. Ruptured blisters need to be covered with a dry and sterile dressing till it has fully healed. This will prevent secondary infections of the wound.

Bullous Pemphigoid Pictures


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