Learn About Bullous Pemphigoid

What is the definition of Bullous Pemphigoid?

Bullous pemphigoid is a skin disorder characterized by blisters.

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What are the causes of Bullous Pemphigoid?

Bullous pemphigoid is an autoimmune disorder that occurs when the body's immune system attacks and destroys healthy body tissue by mistake. Specifically, the immune system attacks the proteins that attach the top layer of skin (epidermis) to the bottom layer of skin.

This disorder usually occurs in older persons and is rare in young people. Symptoms come and go. The condition often goes away within 5 years.

In some cases, the condition is triggered by a medicine.

What are the symptoms of Bullous Pemphigoid?

Most people with this disorder have itchy skin that may be severe. In most cases, there are blisters, called bullae.

  • Blisters are usually located on the arms, legs, or middle of the body. In rare cases, blisters can form in the mouth.
  • The blisters may break open and form open sores (ulcers).
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What are the current treatments for Bullous Pemphigoid?

Anti-inflammatory medicines called corticosteroids may be prescribed. They may be taken by mouth or applied to the skin. More powerful medicines may be used to help suppress the immune system if steroids do not work, or to allow lower steroid doses to be used.

Antibiotics in the tetracycline family may be useful. Niacin (a B complex vitamin) is sometimes given along with tetracycline.

Your provider may suggest self-care measures. These may include:

  • Applying anti-inflammatory creams to the skin
  • Using mild soaps and applying moisturizer to the skin after bathing
  • Protecting the affected skin from sun exposure and injury
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What is the outlook (prognosis) for Bullous Pemphigoid?

Bullous pemphigoid usually responds well to treatment. The medicine can often be stopped after several years. The disease sometimes returns after treatment is stopped.

What are the possible complications of Bullous Pemphigoid?

Skin infection is the most common complication.

Complications resulting from treatment may also occur, especially from taking corticosteroids.

When should I contact a medical professional for Bullous Pemphigoid?

Contact your provider if you have:

  • Unexplained blisters on your skin
  • An itchy rash that continues despite home treatment
Bullous pemphigoid - close-up of tense blisters
What are the latest Bullous Pemphigoid Clinical Trials?
Improving Clinical Trial Recruitment and Outcome Measures in Bullous Pemphigoid
Summary: The purpose of the study is to improve the quality of future clinical trials in bullous pemphigoid (BP), the investigators will monitor repeated measurement data from patients with BP on standard-of-care treatments at four week intervals for four months.
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A Randomized, Part A Partial Blinded and Part B Double Blinded, Placebo-controlled 24-week Clinical Study to Evaluate the Efficacy and Safety of Nomacopan Therapy in Adult Patients With Bullous Pemphigoid Receiving Adjunct Oral Corticosteroid Therapy (ARREST-BP)
Summary: A phase III two-part study of nomacopan, a bifunctional inhibitor of complement component C5 and leukotriene B4 (LTB4), for the treatment of moderate and severe bullous pemphigoid. There is evidence that both terminal complement activation (via C5) and the lipid mediator LTB4 may have a central role in driving the disease. In this study patients will be randomized to receive either nomacopan plus ...
What are the Latest Advances for Bullous Pemphigoid?
Rituximab Therapy for Mucous Membrane Pemphigoid: A Retrospective Monocentric Study With Long-Term Follow-Up in 109 Patients.
Summary: Rituximab Therapy for Mucous Membrane Pemphigoid: A Retrospective Monocentric Study With Long-Term Follow-Up in 109 Patients.
Rituximab, Omalizumab, and Dupilumab Treatment Outcomes in Bullous Pemphigoid: A Systematic Review.
Summary: Rituximab, Omalizumab, and Dupilumab Treatment Outcomes in Bullous Pemphigoid: A Systematic Review.
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Use of rituximab in the treatment of mucous membrane pemphigoid: An analytic review.
Summary: Use of rituximab in the treatment of mucous membrane pemphigoid: An analytic review.
Who are the sources who wrote this article ?

Published Date: April 14, 2021
Published By: Elika Hoss, MD, Senior Associate Consultant, Mayo Clinic, Scottsdale, AZ. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

What are the references for this article ?

Dinulos JGH. Vesicular and bullous diseases. In: Dinulos JGH, ed. Habif's Clinical Dermatology. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 16.

Peña S, Werth VP. Bullous pemphigoid. In: Lebwohl MG, Heymann WR, Berth-Jones J, Coulson IH, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 33.