Bullous pemphigoid is a type of rare skin disorder that makes large, fluid-filled blisters on areas of skin that often flex — like the lower abdomen, upper thighs or armpits. Bullous pemphigoid is most common in people who are older than age 60.
Bullous pemphigoid happens when your immune system attacks a thin layer of tissue below your outer layer of skin. The reason for having this abnormal immune response is unknown, although it sometimes can be triggered by taking specific medications.
Treatment generally includes corticosteroids, such as prednisone, and other drugs that suppress the immune system. Bullous pemphigoid can be life-threatening at times, especially for older people who are already in poor health.
Causes of bullous pemphigoid
The cause of bullous pemphigoid is not well understood. The blisters occur because of a malfunction in the immune system.
Your body's immune system normally produces antibodies to fight against bacteria, viruses or other potentially harmful foreign substances. For various 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 skin's basement membrane, a thin layer of fibers connecting the outer layer of skin (epidermis) and the next layer of skin (dermis).
If torn blisters gets become infected, this can further lead to sepsis — a potentially life-threatening infection that affects your entire body. This serious complication is more likely to occur in older adults who are in generally poor health.
Symptoms of Bullous Pemphigoid
The prime impact of bullous pemphigoid is the appearance of large blisters that don't easily rupture when touched. The fluid inside the blisters is usually clear but may contain some blood. The skin around the blisters may appear normal or red.
In most cases, the blisters are seen on the lower abdomen, groin, upper thighs and arms. Mostly, blisters are located along with the creases or folds present in the skin, like the skin on the inner side of a joint.
The affected areas of skin can be very itchy. You might also develop blisters or sores in your mouth. Rarely, the mucous membranes which are present in the eyes can be involved, creating much redness, soreness and discomfort.
Treatment and Drugs for Bullous Pemphigoid
The main focus of bullous pemphigoid treatment is to help the skin heal as quickly as possible and relieve itching. Your doctor will prescribe a combination of medicines that inhibit immune system activities that cause inflammation. These drugs may include:
The most common treatment is prednisone, which comes in pill form. However, long-term use can increase your risk of weak bones, diabetes, high blood pressure, high cholesterol and cataracts. Corticosteroid ointment can be used on your affected skin and cause fewer side effects.
A variety of drugs with anti-inflammatory properties may be used alone or in combination with corticosteroids. Examples can be methotrexate (Trexall), a rheumatoid arthritis drug tetracycline, an antibiotic with anti-inflammatory properties and dapsone (Aczone), a leprosy treatment.