Bullous pemphigoid

Bullous pemphigoid is a skin disease featuring large blisters filled with fluids which affect those skin areas that experience persistent stretching, such as the lower abdomen, the armpit muscles, and the upper thighs. Bullous pemphigoid is an uncommon disease and typically affects individuals over 60 years old.

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Bullous pemphigoid is caused when the immune system mistakenly attacks the thin layer of tissue that occurs just below the topmost skin layer. Doctors are not aware of the precise causes for such abnormal immune sysftem behavior. It has however been found that the anomalous immune reaction may get triggered due to consumption of certain medications.

Bullous pemphigoid is generally treated with corticosteroids and other kinds of prescription drugs that inhibit the immune system. It is important to note that bullous pemphigoid can lead to dangerous medical complications, primarily in elderly patients who have pre-existing health abnormalities.

Symptoms of bullous pemphigoid

Listed below are some common signs and symptoms of bullous pemphigoid:

  • The primary symptom of bullous pemphigoid by which it can be readily diagnosed, is the development of large blisters which do not burst easily. The blisters are full of fluids, and they can either be clear or have a bloody tinge. The surrounding skin areas may be either reddish or normal.
  • In most cases, the blisters form on the lower abdomen, groin, upper thighs, and arms. They generally form in those parts of the body which have skin creases or folds, such as the inside section of different joints.
  • Some bullous pemphigoid patients may also suffer from blisters or sores in the mouth. Uncommonly, the mucous membranes of the eye may also get affected, thereby causing redness, distress, and soreness in the eyes.Oral or ocular bullous pemphigoid blisters can also result in permanent marks or scarring.
  • Sometimes, the blisters may rupture and leave an open wound in its wake. Such large open wounds are vulnerable to secondary infections by bacteria or other pathogens. It can also result in widespread infection called sepsis which is a life-threatening condition. This deadly complication however tends to occur in the elderly with failing or poor health.

Since bullous pemphigoid can cause fatal complications, all instances of blisters on skin with no definite causes like an allergic reaction, etc., need to be examined by a doctor.


Doctors do not know the exact cause of bullous pemphigoid. It has however been found that the skin disorder is caused because of some immune system malfunction.

A healthy immune system normally produces different types of antibodies to fight off varied germs and infections. However, in people with bullous pemphigoid, the immune system erroneously makes an antibody that attacks a particular healthy skin tissue. Researchers are still trying to find out the causes of this immune system dysfunction.

The thin layer of skin, which acts as a link between the epidermis or the upper skin layer and the dermis or the inner skin layer, gets attacked by the abnormal antibody produced in patients of bullous pemphigoid. Such an attack causes inflammation of the skin leading to itching and development of the abnormal blisters.

Bullous pemphigoid is commonly diagnosed in the elderly who are more than 60 years old. The susceptibility increases with a progress in the age.

There are no known risk factors which can trigger bullous pemphigoid. It forms at random. A few studies have however suggested that certain medical treatments may be related to bullous pemphigoid formation, albeit very rarely.

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  • Radiation therapy to treat certain cancers, and UV light therapy to remedy some skin conditions, have been found to trigger an episode of bullous pemphigoid.
  • Bullous pemphigoid can also develop due to use of some prescription drugs like penicillin, furosemide, sulfasalazine, and etanercept.

Treatment of bullous pemphigoid

Doctors prescribe different kinds of medicines to constrain the immune system, treat, and fully heal the bullous pemphigoid blisters. Drugs are also given to lessen the itching.

  • Abnormal immune system behavior is suppressed with immunosuppressant drugs.
  • Topical and/or oral corticosteroids may be used to mitigate skin inflammation.
  • The use of corticosteroids may sometimes be followed along with intake of anti-inflammatory drugs. The latter may also be used as a standalone therapy.

Patients may follow the below listed self-care measures to alleviate the varied signs and symptoms of bullous pemphigoid:

  • Avoid exposure to the sun for long periods of time. Properly protect all skin regions with the abnormal blisters whenever there is a need to be outdoors.
  • People with bullous pemphigoid blisters in the mouth should abstain from hard and crunchy foods such as chips, raw vegetables, and raw fruits, etc. Intake of such food items can aggravate the symptoms.
  • The presence of bullous pemphigoid blisters as well as use of corticosteroid therapy to treat it, causes the skin to become fragile. It is therefore important to ensure that skin injuries do not occur. If the blisters rupture, then patients need to visit a doctor and bandage the resultant wound to prevent secondary infections.

Bullous pemphigoid pictures

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