Note: All links within content go to MayoClinic.com
Diseases and Conditions
Bullous pemphigoidFrom MayoClinic.com
Special to CNN.com
Bullous pemphigoid is a rare, chronic condition in which fluid-filled blisters (bullae) erupt on the surface of your skin, usually on your arms and legs. The cause of bullous pemphigoid is unknown, but it may be related to a disorder of the immune system.
Bullous pemphigoid typically occurs in older adults. The condition is seldom life- threatening, but the medications used to treat bullous pemphigoid can cause complications. Without treatment, bullous pemphigoid may persist, with periods of remission and flare-ups, for many years.
Signs and symptoms
Signs and symptoms of bullous pemphigoid range from mild to severe. Some people might only notice a slight redness and irritation on their skin, while others may experience multiple blisters. The bullae typically develop on your arms, legs or trunk but can also occur in your mouth or other mucous membranes.
The blisters appear as firm, fluid-filled sacs at least 1 centimeter in diameter. They may weep or appear crusty. In some cases, the blisters may form painful, open sores on the surface of your skin.
Other signs and symptoms may include:
Bullous pemphigoid is a disorder in which antibodies produced by your immune system attack a thin layer of connective tissue in your skin (basement membrane). It's not certain what causes antibodies to attack healthy tissue in your body. If the delicate basement membrane becomes inflamed, fluid-filled blisters can form.
Bullous pemphigoid is most likely to occur in people who are 60 years of age and older. The condition is uncommon in young people.
When to seek medical advice
If you develop an unexplained blistering on your skin or an itchy rash, talk to your doctor. Bullous pemphigoid is usually evaluated by a doctor who has special training in diagnosing and treating skin conditions (dermatologist).
Screening and diagnosis
The characteristic fluid-filled blisters are often the first indication that you may have bullous pemphigoid. Usually, your doctor will take a sample of your skin (biopsy) and conduct special tests under a microscope. Your doctor may also order a blood test to confirm the presence of antibodies associated with bullous pemphigoid.
The most common complications of bullous pemphigoid arise from the medications used to treat the condition. Drugs called immunosuppressants help treat bullous pemphigoid, but they also subdue your immune system, which may increase your likelihood of developing certain infections and cancers. Taking corticosteroids over long periods of time may increase your risk of osteoporosis and bone fractures.
Bullous pemphigoid can also affect your quality of life. Blisters appearing in your mouth may make it more difficult for you to eat. You may find that it's tricky to complete your daily activities if you have ruptured blisters or blisters on the palms of your hands or soles of your feet. Also, bullous pemphigoid occurring in the eyes can lead to scarring.
The goal of treating bullous pemphigoid is usually to reduce inflammation — thereby easing the symptoms — and suppressing the autoimmune response in your skin.
With therapy, bullous pemphigoid usually disappears within one and a half to five years. However, left untreated, the condition may disappear spontaneously after a couple months or persist for years.
There's no prevention for bullous pemphigoid. Certain drugs provoke a reaction that produces blisters similar to those of bullous pemphigoid in some people. If you notice any skin problems after beginning a medication, talk to your doctor.
If you have bullous pemphigoid, you can help take care of your condition in several ways. Here are a few ideas:
June 09, 2006