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What is Bullous Pemphigoid ?

Bullous pemphigoid (BP) is a chronic blistering of the skin. It is an autoimmune eruption of tense bullae i.e. the blisters are due an immune reaction within the skin. The vast majority of those affected are elderly, but it has been seen at all ages.

It ranges from mildly itchy welts to severe infection, and may affect a small area of the body or be widespread. The blisters are large and can occur anywhere on the skin but are more common on the skin fold areas such as the groin and armpits. Bullous pemphigoid can also involve the mouth. This disease is not a fatal disease and is usually cured easily. Lesions are concentrated on the inner arms and inner thighs and may appear on an erythematous or a non-erythematous base.  One-third of patients have oral lesions. 

Causes of Bullous Pemphigoid:

Some important causes of bullous pemphigoid includes:-

  • Skin Antibodies can be detected circulating in the blood stream of the patient of bullous pemphigoid.
  • The side-effects due to some medicines - like furosemide, sulphasalazine, penicillins, and captopril may lead to formation of bullous pemphigoid.
  • Bullois Pemphigoid is an autoimmune disease. In this disease, antibodies are made against the membrane between dermis and epidermis layers of the skin. This means that the cells in the body that normally fight infection or germs attack the skin cells, causing blisters.
  • Pernicious anaemia, rheumatoid arthritis, and vitiligo are also one of the main causes of bullous pemphigoid.
  • Bullous pemphigoid occurs more commonly in elderly persons and is very rare in young people. It is usually characterized by a pattern of exacerbations and remissions.
  • It is not contagious disease i.e. cannot be transmitted from one person to other.
  • Some viruses, infection, prolonged sitting in sunlight, or other factors can also lead to the condition of bullous pemphigoid.

Symptoms of Bullous Pemphigoid

Bullous Pemphigoid have following symptoms -

  • Usually the skin is very itchy and large, red welts and hives may appear before or during the formation of blisters.
  • Rash may be present.
  • Bullous pemphigoid also develop blisters in the mouth or down the throat in the esophagus.
  • Skin ulcers may form.

Treatment of Bullous Pemphigoid:

There is no medical cure for bullous pemphigoid as such. The condition can only be kept in controlled with some medications so that it may not become more severe. The only perfect cure for bullous pemphigoid is time, and as time will pass it will automatically dissapear on its own.

Some of the Treatment options which can keep Bullous Pemphigoid undre control includes:-

  • Topical Steroids are very effective, usually clobetasol propionate for the fast recovery.
  • Some antibacterial ointment can also be used to prevent skin infection.
  • The skin infection can be controlled by using drugs, like Dapsone, Prednisone and Imuran.
  • The topical cortisone creams can resolve bullous pemphigoid, but sometimes requires high doses of cortisone taken internally.
  • Nicotinamide may also be used in the chronic condition.
  • High dose intravenous immunoglobulin is useful for the reduction of blisters from the skin.
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