Bullous Pemphigoid

Bullous Pemphigoid

Bullous pemphigoid (BP) is a non-contagious autoimmune condition characterized by blisters on the skin. These form when antibodies mistakenly attack proteins that help connect the outer skin layer (epidermis) to the deeper skin layer (dermis), causing them to separate. It often initially presents as itchy patches of rash that may appear dark reddish-brown on darker skin, or redor pink on lighter skin tones. Weeks to months later, blisters begin to form and can range in size from small to large.

The condition primarily affects persons over the age of 60, and lasts anywhere from months to years. It can resolve naturally; however, there are treatment options, depending on disease severity. These range from topical steroid creams to oral medications (steroid tablets or antibiotics) to injectable or IV medications. Healed patches may appear slightly darker, but usually do not scar. Complications of BP include skin infections and sepsis due to burst blisters, making good skin hygiene essential in managing this condition.

Prodomal Phase
Moderate-to-severe itchy skin associated with raised skin rash
Active Phase
Multiple 1 cm to 4 cm large blisters filled with clear fluid and slight erythematous skin
Blisters on darker skin: Dusky pink, brown, or black
Blisters on lighter skin: Yellow, pink, or red
Inactive Phase
Healed patches may appear slightly darker
Separation of epidermis from dermis

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