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Pemphigoid, Bullous

Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Bullous pemphigoid (BP) is a chronic, acquired autoimmune subepidermal blistering skin disorder caused by linear deposition of autoantibodies against the epithelial basal membrane zo...

DIAGNOSIS

HISTORY

  • BP occurs sporadically without any obvious trigger factor.

  • Prodromal nonbullous phase: mild to severe pruritus, associated with excoriated, eczematous, and often urticarial plaques

  • Muco...

TREATMENT

GENERAL MEASURES

  • Discontinue trigger factors.

  • In oral lesions: Avoid hard consistency, spicy, and hot food. Soft and liquid meals should be given instead.

  • Strict control of wounds to avoid comp...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Taper medication when disease is stable and control side effects.

  • Perform periodic skin examination for new lesions.

  • Frequent bacterial cultures o...

REFERENCES

1
Marazza G, Pham HC, Schärer L, et al; and Autoimmune bullous disease Swiss study group. Incidence of bullous pemphigoid and pemphigus in Switzerland: a 2-year prospective study. Br J Derma...

ADDITIONAL READING

  • García-Romero MT, Werth VP. Randomized controlled trials needed for bullous pemphigoid interventions. Arch Dermatol.  2012;148(2):243–246.

  • Gürcan HM, Ahmed AR. Analysis of curre...

CODES

ICD10

L12.0 Bullous pemphigoid 

ICD9

694.5 Pemphigoid 

SNOMED

  • 77090002 Bullous pemphigoid (disorder)

  • 402440008 oral mucous membrane involvement by bullous pemphigoid (disorder)

  • 403629000 drug-induced b...

CLINICAL PEARLS

  • Tense bullae differentiates the lesions of BP from the flaccid bullae of pemphigus vulgaris.

  • Low doses of potent topical steroid have been shown to be just as effective as larger amount...

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