Bullous pemphigoid

Symptoms

• Bullous: The main characteristic of bullous pemphigoid is the presence of tense, large bullae that can appear on healthy or inflamed skin. These bullae are often itchy and filled with clear fluid.
• Itching: Many patients experience significant itching, which may precede the appearance of lesions.
• Skin changes: Affected skin may show redness, swelling, and inflammation.

Causes

The exact cause of bullous pemphigoid remains unclear. It likely involves a combination of genetic factors and environmental triggers. Certain medications can also worsen the condition, including:

• Diuretics (e.g. furosemide)
• Antibiotics (e.g. penicillins, sulfonamides)
• Nonsteroidal anti-inflammatory drugs (NSAIDs) (e.g. ibuprofen)
• Vaccines

Diagnosis

• Diagnosis involves a clinical examination of the skin and may include:
• Biopsy: A skin sample is taken for analysis under a microscope.
• Direct immunofluorescence: This test detects specific antibodies in the skin, indicating an autoimmune reaction.

Treatment

Treatment focuses on relieving symptoms and promoting healing:

• Corticosteroids: Topical or systemic corticosteroids are commonly prescribed to reduce inflammation and suppress the immune response.
• Immunosuppressants: In more severe cases, drugs that suppress the immune system may be used (Azathioprine / Mycophenolate / Cyclosporine / Methotrexate).
• Wound care: Proper management of blisters is critical to avoid infections and facilitate healing.

Most people with bullous pemphigoid experience significant improvement with appropriate treatment.