Bullous Pemphigoid Information and Treatment 

Bullous pemphigoid is a skin problem identified by large blisters. It varies from mildly itchy welts to severe blisters and infection, and may affect a small area of the body or be widespread. Bullous pemphigoid (BP) is a incessant, autoimmune, subepidermal, blistering skin disease which rarely includes mucous membranes. A majority of cases happens in persons 80 years of age or older.

Bullous pemphigoid is diagnosed based on the results of a skin biopsy, that can espy the abnormal antibodies deposited in the basement membrane layer of skin. The blisters of bullous pemphigoid normally appear on the areas of the body that flex or move (flexural areas). Bullous pemphigoid generally occurs in elderly persons and is unusual in young people. BP is detected by the presence of immunoglobulin G (IgG) autoantibodies especial for the hemidesmosomal BP antigens BP230 (BPAg1) and BP180 (BPAg2).

Bullous is the medical name for a big blister (a thin-walled sac filled with clear fluid). It is an immunobullous disease, i.e. the blisters are formed because of an immune reaction within the skin. BP is not infectious and you cannot 'grab' it from an affected person.

The disorder commonly affects elderly people, but it may occur sometimes in children. The blisters come up on the skin and less common in the mouth too. Yet another form of pemphigoid (pemphigoid gestationis) develops during pregnancy.

The cause is not known, but may be related to immune system disorders. Around one-third of persons having bullous pemphigoid also form blisters in the mouth. Therapy must be characterized for each patient, reminding in mind pre-existing conditions and other patient-specific factors.

The common treatment is to take steroid tablets such as prednisolone. Medications can involve chemotherapy or immunosuppressive medications like methotrexate, azathioprine, mycophenolate, or cyclophosphamide.