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Bullous Pemphigoid


Bullous pemphigoid (BP) is a chronic, autoimmune, subepidermal, blistering skin disease which rarely includes mucous membranes. It varies from mildly itchy welts to severe blisters and infection, and may affect a small area of the body or be widespread. Nearly one-third of persons with bullous pemphigoid also develop blisters in the mouth. The complication may occur in divergent forms, from no symptoms, to mild redness and irritation, to multiple blisters. A majority of cases happens in persons 80 years of age or older. It is an immunobullous disorder, i.e. the blisters are due an immune reaction within the skin.

Bullous pemphigoid is very rare in children. Men and women are equally influenced. BP is not contagious and you cannot 'catch' it from an affected person. The condition is caused by antibodies and inflammation abnormally aggregating in a certain layer of the skin called the "basement membrane." It is identified by a pattern of exacerbations and remissions. In majority of patients, the disease spontaneously clears within 6 years. The blisters can arise in small regions on the body or can be quite widespread.

BP is a non-scarring blistering disease, typically with a flexural dissemination of skin lesions. Certain lifestyle and environmental factors reportedly play a role in focussing bullous pemphigoid. A dermatologist can usually make the diagnosis by examining the skin carefully. In some cases, the diagnosis will be ingrained by a skin biopsy of a typical blister. It can also (albeit only rarely) embody the mucous membranes, and has been shown to afflict dogs, cats, pigs, and horses, as well as humans.

People having BP have a slightly higher than average chance of developing other auto-immune diseases such as pernicious anaemia, rheumatoid arthritis, and vitiligo. Generally the skin in BP is very itchy and large, red welts and hives may appear prior to or during the formation of blisters. Some patients suffering from BP have other autoimmune diseases such diabetes and rheumatoid arthritis. Different other factors have been reported to play a role in triggering BP. Less than 15% of patients having BP develop blisters on mucous membranes such as the mouth, nose, or eyes.

Causes of Bullous pemphigoid

The common causes and risk factor's of Bullous pemphigoid include the following:

  • Bullous pemphigoid is an autoimmune disease. This means that the cells in the body whch normally combat infection or germs attack the skin cells, causing blisters.
  • Certain lifestyle and environmental factors reportedly play a role in triggering bullous pemphigoid.
  • Blisters in the mouth or esophagus are also play a role in triggering bullous pemphigoid.
  • Viruses, sunlight, or other factors.
  • Antibodies and inflammation abnormally accumulating in a certain layer of the skin called the "basement membrane."
  • Bullous pemphigoid can be chronic and mild without affecting the general health of affected individuals.

Symptoms of Bullous pemphigoid

Some sign and symptoms related to Bullous pemphigoid are as follows:

  • Mouth sores.
  • Large blistering lesions in flexural areas, i.e., the creases of the body.
  • Bleeding gums.
  • Small patches of itchy skin are typical at first.
  • Itching.
  • General ill feeling.
  • Rashes.

Treatment of Bullous pemphigoid

Here is list of the methods for treating Bullous pemphigoid:

  • Some patients with bullous pemphigoid are treated with steroid tablets, usually prednisone.
  • Tetracycline and Minocycline antibiotics are very useful for mild to moderate disease.
  • Patients with oral disease may require an otolaryngologist and/or a dentist for evaluation and care.
  • Other medications may include chemotherapy or immunosuppressive medications such as methotrexate, azathioprine, mycophenolate, or cyclophosphamide.
  • Corticosteroids are the treatment of choice. They are given by mouth or by injection. Topical (applied to a localized area of the skin) corticosteroids may also be used on early, localized lesions.
  • Topical steroid creams, lotions, and ointments are effective in mild cases of bullous pemphigoid and as combination therapy for more severe cases.