MedlinePlus Medical Encyclopedia: Bullous pemphigoid

Skip navigation


Medical Encyclopedia
Other encyclopedia topics:	A-Ag Ah-Ap Aq-Az B-Bk Bl-Bz C-Cg Ch-Co Cp-Cz D-Di Dj-Dz E-Ep Eq-Ez F G H-Hf Hg-Hz I-In Io-Iz J K L-Ln Lo-Lz M-Mf Mg-Mz N O P-Pl Pm-Pz Q R S-Sh Si-Sp Sq-Sz T-Tn To-Tz U V W X Y Z 0-9

Bullous pemphigoid

Contents of this page:
Illustrations Definition Causes, incidence, and risk factors Symptoms Signs and tests	Treatment Expectations (prognosis) Complications Calling your health care provider

Illustrations

Bullous pemphigoid, close-up of tense blisters

Definition Return to top

Bullous pemphigoid is a skin disorder characterized by large blisters.

Causes, incidence, and risk factors Return to top

The blisters of bullous pemphigoid usually appear on the areas of the body that flex or move (flexural areas). About one-third of persons with bullous pemphigoid also develop blisters in the mouth. The disorder may occur in various forms, from no symptoms, to mild redness and irritation, to multiple blisters. The cause is not known, but may be related to immune system disorders.

Bullous pemphigoid typically occurs in elderly persons and is rare in young people. It is characterized by a pattern of exacerbations and remissions. In most patients, the disease spontaneously clears within 6 years.

Symptoms Return to top

bullae (large blisters, thin walled sacs filled with clear fluid, greater than 1 cm. diameter)
- multiple
- usually located on the arms, legs, or trunk
- may also occur in the mouth
- may weep, crust over
- may appear deep below the surface of the skin
- may erode the skin, form ulcers or open sores
itching
rashes
mouth sores
bleeding gums

Signs and tests Return to top

A skin lesion biopsy shows a characteristic blistering pattern. A special type of skin biopsy may also be performed and examined by direct immunofluorescence. Some physicians may additionally order blood tests to help confirm the diagnosis.

Treatment Return to top

Treatment is focused on relief of symptoms and prevention of infection.

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.

Other medications may include chemotherapy or immunosuppressive medications such as methotrexate, azathioprine, mycophenolate, or cyclophosphamide. Antibiotics in the tetracycline family may be useful in mild cases. Niacin (a B complex vitamin) is sometimes given along with tetracycline.

Expectations (prognosis) Return to top

Bullous pemphigoid usually responds well to treatment. In most patients, all medications may be stopped after several years. In a small group, however, the disease will recur after treatment is stopped.

Complications Return to top

Infection of the skin lesions is the most common complication.

Calling your health care provider Return to top

Call your physician if you notice unexplained blisters on your skin, or, an itchy rash persists despite home treatment.

Update Date: 8/15/2003

Updated by: Michael Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.