Bullous Pemphigoid: A Clinical Summary

Kalafhi Medical Centre | Tuesday May 21, 2024 06:01

Bullous pemphigoid (BP) is an autoimmune blistering disease. In a healthy person, the immune system protects the body from invaders. In BP, the immune system mistakenly attacks healthy skin tissue, leading to the formation of blisters.

Causes:

The exact cause of BP is unknown, but it's believed to be a combination of genetic predisposition and environmental triggers. Certain medications and underlying medical conditions may also play a role.

Clinical Features:

Itching: Intense itching, sometimes preceding the appearance of blisters, is a common symptom.

Blisters: Tense, fluid-filled blisters that arise on normal or reddened skin, typically on the flexural areas (groin, armpits, inner thighs) and mucous membranes (mouth).

Nikolsky's sign: A diagnostic test where gentle pressure on apparently healthy skin causes the top layer to separate, revealing a raw, underlying area.

Diagnosis:

Physical examination: A dermatologist will examine the skin and may perform Nikolsky's sign.

Biopsy: A small skin sample is taken and examined under a microscope to confirm the presence of subepidermal blisters, a hallmark of BP.

Direct immunofluorescence (DIF): A test that detects specific immune deposits in the skin, helping differentiate BP from other blistering diseases.

Treatment:

Corticosteroids: Topical or oral steroids are the mainstay of treatment to suppress the immune response.

Immunosuppressants: Medications like azathioprine or mycophenolate mofetil may be used alongside steroids to reduce the dosage and side effects.

Wound care: Proper wound care is crucial to prevent infection and promote healing of existing blisters.

Source: Dr Aloosh