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Patient education: Bullous pemphigoid (The Basics)

Patient education: Bullous pemphigoid (The Basics)

What is bullous pemphigoid? — Bullous pemphigoid is a condition that causes blisters on the skin. Blisters are fluid-filled bumps on the skin.

Bullous pemphigoid is an autoimmune disease. An autoimmune disease is when the body's infection-fighting system attacks healthy tissue instead of infections. Sometimes, bullous pemphigoid happens after people take certain medicines.

This condition happens most often in adults age 60 and older.

What are the symptoms of bullous pemphigoid? — Most commonly, bullous pemphigoid causes large blisters to form on the skin (picture 1). Most blisters happen on the trunk, arms, legs, armpits, or groin. But they can happen all over the body. The blisters can come and go. After a blister pops, you might see an open sore. These sores usually heal without a scar.

People with bullous pemphigoid also often have raised areas of skin. These might be red or skin-colored. The raised areas can be under the blisters or in other places (picture 2). Some people have only the raised areas of skin and no blisters. Itching is common.

Some people with bullous pemphigoid also get sores in their mouth. These sores can hurt and can make it hard to eat.

Is there a test for bullous pemphigoid? — Yes. To check whether your symptoms are caused by bullous pemphigoid, your doctor will do a test called a skin biopsy. They will remove small samples of tissue from a blister or from the raised areas of skin. Then, another doctor will do tests on the samples and look at them under a microscope. Your doctor might also order special blood tests.

Is there anything I can do on my own to manage my symptoms? — Yes. Do not pop your blisters unless your doctor tells you to. Also, follow your doctor's instructions about how to take care of your sores. That way, your skin is less likely to get infected.

How is bullous pemphigoid treated? — Treatment usually includes 1 or more of the following:

Steroid creams or ointments – These medicines can reduce inflammation and itching and prevent new blisters from forming.

Steroid pills – Steroid pills can also reduce blisters, inflammation, and itching. Since steroid pills can have side effects, it is important that you take them exactly as prescribed. You should also see your doctor for regular follow-ups.

Other medicines that "calm down" the immune system

Treatment usually lasts 1 to 2 years or longer. Sometimes, symptoms return after treatment.

More on this topic

Patient education: Blisters (The Basics)
Patient education: Side effects from medicines (The Basics)
Patient education: Brand versus generic medicines (The Basics)
Patient education: Taking medicines when you're older (The Basics)

This topic retrieved from UpToDate on: Aug 01, 2023.
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