Bullous Pemphigoid

Bullous Pemphigoid: Symptoms, Cause and Treatment

What is Bullous Pemphigoid?

Bullous Pemphigoid is referred as BP by dermatologists. This is a very serious kind of skin disorder characterized by chronic blisters on the surface of the skin affected. This condition can vary in severity. Its wounds may be mildly itchy or may be sever blisters with sever infection. It may affect a small area of the skin or may affect the whole body. It is more common in areas where there are skin folds like armpit and groins. Though people of any age are at risk but it is seen mostly in elderly people. It can also affect the inner lining tissue of the mouth.


Bullous Pemphigoid is not a common skin disorder and is rarely life-threatening. It is an autoimmune skin disorder whose cause is not known. Large blister is known as Bullous in medical glossary. This is a thin walled sac which is filled with clear fluid. Skin in these bullous is very itchy, red and hives may appear during formation of blisters. It is super epidermal disease which rarely involves mucous membranes tissues.


What Are the Symptoms OF Bullous Pemphigoid

 Bullous Pemphigoid can be identified by its various symptoms. First and the most significant symptoms of this disorder is presence of large blisters called Bullous. They are thin walled sacs containing clear fluid. They are many in numbers, usually present on arms, legs or trunks. Sometimes, they occur in mouth also or may appear deep below the surface of the skin. It can lead to ulcers also. Other symptoms of this skin disorder are rashes, bleeding gums, mouth sores and itching.


What Are Causes of Bullous Pemphigoid

Exact cause of Bullous Pemphigoid is not known; it is an autoimmune disease. Autoimmune disorder is caused by malfunctioning of immune system of the body; the body cells which are supposed to fight infection or germs produce antibodies against the healthy cells and attack the skin cells which cause blisters. It is observed that patients suffering from Bullous Pemphigoid, also suffer from other autoimmune diseases like diabetes. There are some other factors too which are known to trigger this skin disorder. These factors may include immune suppressing drugs like azathoprine, mechanical trauma and physical trauma like burns from sunrays, heat or radiations. This disorder can be severe or mild, without disturbing the general health of the person.


How Bullous Pemphigoid is diagnosed?

 This skin disorder has various degrees of symptoms; it becomes difficult to confirm it by just examining the disease. Confirmed diagnosis is done by skin biopsy only. A specialized skin biopsy test is done which is known as direct immunoflorecsence biopsy. In addition, blood tests are done.


What Are the Treatments For Bullous Pemphigoid?

Treatment of Bullous Pemphigoid is done by easing the symptoms and preventing the infection.


For mild and moderate degree of BP, Tetracycline and Minocycline antibiotics are administered. These antibiotics act directly upon the immune system instead of attacking bacteria. These oral medicines are generally used along with application of topical steroid creams. It brings early relief to the patient.


For severe cases of BP, oral steroids such as prednisone, prednisolone, are used. Treatment is started with very high dose of steroids and patients have to pay regular visits to the dermatologist because dose of the medicines has to be adjusted. Taking steroids because serious side effects too, so they have to be monitored by the doctor. It is a long treatment. After initial high dose, when blisters stop appearing, dose of medicine is reduced over months. Dermatologist tries to keep the dose as low as possible looking at the side effects. To keep the side effects, caused by steroids low, immunosuppressive agents such as, Cellcept, Methotrexate, cyclophosphamide Neoral and Immuran are used with steroids.


For very severe, infectious cases, it is better to be treated at hospital so that wounds can be dressed and intravenous injections can be given for more powerful treatment.


Bullous Pemphigoid is a self limiting skin disorder, which clears up itself after some time of treatment and dose is reduced or stopped. But this skin disorder also has the tendency of flare-ups and can return back suddenly after 5-6 years. The basic advice for the patients is to be calm and have positive attitude. Monitor the changes and follow the instructions and medicines regularly and patiently for getting the most effective results.


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