Bullous pemphigoid is an autoimmune disorder that causes blistering of the skin. It is a long-term condition that is most common in the elderly.
The immune system normally attacks foreign matter to prevent or stop infections. When the immune system attacks healthy tissue it is called an autoimmune disorder. In bullous pemphigoid, the immune system attacks tissue just below the top layer of skin.
Bullous pemphigoid is more common in people aged 60 years and older.
In a small number of cases bullous pemphigoid may occur after:
Severe itching of the skin is often the first sign. Eventually a rash and blistering will develop. Blisters are usually clear and are most commonly seen on the arms, legs, abdomen, and mouth, usually along creases in the skin. The blisters can break and form ulcers.
It may be a few years between the start of itching and the appearance of a rash.
You will be asked about your symptoms and medical history. A physical exam will be done. You may be referred to a skin specialist.
Tests may be done to help distinguish bullous pemphigoid from other conditions with similar symptoms. Tests may include:
Bullous pemphigoid responds well to treatment and usually resolves completely within 5 years. Talk with your doctor about the best treatment plan for you. Options include:
Certain medications may help lower the immune system and decrease damage to the skin. Medication options may include:
Antibiotics or antiseptic medications may also be used to prevent or treat infections in broken skin.
Blisters will be left intact when possible. However, blisters that interfere with daily tasks may be drained.
Proper skin care will decrease the risk of infection in damaged skin.
American Academy of Dermatology
American Osteopathic College of Dermatology
Canadian Dermatology Association
Bullous pemphigoid. American Osteopathic College of Dermatology website. Available at: http://www.aocd.org/?page=BullousPemphigoid. Accessed April 5, 2016.
Bullous pemphigoid. Cleveland Clinic website. Available at: https://my.clevelandclinic.org/health/diseases_conditions/hic-bullous-pemphigoid. Updated July 13, 2015. Accessed April 5, 2016.
Bullous pemphigoid. DermNet NZ website. Available at: http://www.dermnetnz.org/immune/pemphigoid.html. Updated January 2016. Accessed April 5, 2016.
Bullous pemphigoid. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated July 15, 2015. Accessed April 5, 2016.
Bullous pemphigoid. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/dermatologic-disorders/bullous-diseases/bullous-pemphigoid. Updated June 2013. Accessed April 5, 2016.
Bullous pemphigoid. NHS Choices website. Available at: http://www.nhs.uk/conditions/bullous-pemphigoid/Pages/bullous-pemphigoid.aspx. Updated December 5, 2015. Accessed April 5, 2016.
Bullous pemphigoid. Primary Care Dermatology Society website. Available at: http://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1. Accessed April 5, 2016.
Last reviewed April 2016 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.