Bullous Pemphigoid: Causes, Symptoms, Diagnosis and Treatment

Treatment of Bullous Pemphigoid

With Bullous Pemphigoid the immune system is malfunctioning which makes it an autoimmune disorder. It attacks the healthy body cells without an infection rather than defending the body. Inflammation is the result. Chronic blistering of the skin is termed Bullous Pemphigoid and it normally appears in individuals over fifty years of age. The blistering can be anything from mildly itching small welts to very large and painful blisters that are accompanied by severe infection. The blisters are either localized to a small area or widespread. Large blisters filled with clear fluids is medically termed Bullous. They can be found in the mouth and esophagus, but they typically appear at the flexural areas. After sufficient treatment it normally clears up completely which makes it a self-containing disease but it can reappear after some years. Both men and women are at risk of this disease and children may also develop the condition. It may be hereditary but it is not contagious.


Over a period of months the skin lesions which are referred to as bullae start off as red wheals and evolve into large blisters. Typically these lesions are red and oval to round shaped. Painful erosions of the skin may occur if they rupture. Itching and pain may also be experienced. They are mostly found at the lower legs, stomach, inner thighs and armpits but they can also sometimes be found in the mouth, vagina area and anus as well. When you scratch them some of the lesions may become infected and painful.


Bullous Pemphigoid may affect someone who suffers from other immune disorders such as diabetes. The appearance of blisters can also be triggered by a number of drugs such as penicillin and furosemide. Blisters can also be triggered to appear by burns from radiation and the sun.


A skin biopsy is needed for the correct diagnosis of Bullous Pemphigoid since there are so many different symptoms and degrees. Outpatient facilities can perform this skin biopsy. The severity and location of the blister will determine the method used for the biopsy. Typically a local anesthetic is administered. The removal of the top layers of skin is entailed in the shave biopsy. When the skin lesions are deeper then a punch biopsy is performed and this is where a small part of the skin is removed with a hollow instrument and then the wound is closed with stitches. With Bullous Pemphigoid blood tests are not conclusive.


Bullous Pemphigoid has no cure. Prevention of infection and relief of the symptoms is the focus of treatment. To treat mild symptoms certain antibiotics such as Tetracycline and Mincolycine can be used. These antibiotics cannot be used for long periods of time without damaging a person's health due to their side effects. For severe Bullous Pemphigoid cases oral steroids may be prescribed. The prescription is adjusted accordingly as the dermatologist monitors the patient closely. Severe side effects accompany the steroids. Months or even years may be required for treatment. To lower the dosage of oral steroids other immunosuppressive agents may be used. To allow intravenous injections severe cases are typically hospitalized. To ensure that the body doesn't act against healthy cells then immunosuppressive agents are used to suppress the immune system. You should take cleansing baths regularly and dress the wounds to keep them clean. To prevent outbreaks and secondary infections it is important to keep good skin hygiene. Make sure you don't scratch the bullae or wear clothes that can itch or rub against them.

What Can You Do to Prevent Large Outbreaks?

If possible you shouldn't partake in any activities that cause excessive sweating. If you must do an activity then you should take a shower or bath immediately after and allow your body to air dry. Use a hypoallergenic detergent to wash your clothes. Treat any secondary infections immediately and check for them regularly.


When you have bullae in your mouth and throat you should follow a liquid or soft diet to prevent eruptions. It is important to have a nutritious and balanced diet. Especially important are magnesium, selenium, manganese and Vitamins A, C, E and B complex. To help the body fight against secondary infections it is important to have antioxidants such as Vitamins C and E. Fiber is another thing you should eat plenty of. Outbreaks and inflammation can be reduced by a number of herbs and phytonutrients. Some of these include Siberian ginseng, St. John's wort, turmeric, 5HTP, ginger, garlic, devil's claw, peppermint oil, boswellia, bromelain, acetyl-glycocemine, gamma oryzanol, grape seed extract and licorice. Bacteria is killed by the garlic. With proper care, treatment and diet people with Bullous Pemphigoid can live normal lives.

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