What is Bullous Pemphigoid?
This is a rare skin condition and is usually found in the areas of your skin that flex such as your armpits, lower abdomen, or upper thighs under the upper layers of your skin. It can be widespread or located in one area. Bullous Pemphigoid causes large blisters that are filled with fluid on these areas of your skin. These blisters will normally not rupture easily when touched. Inside these blisters the fluid is clear but there are some that may contain a little blood. If they do rupture they can be painful and sensitive. It is a considered a chronic blistering of your skin and the blisters can range from mild itchy welts to infection and severe blisters.
You will find this condition usually in people who are older than sixty years of age but it can affect people of all age groups. This condition will usually spontaneously disappear in several months but could take years. Bullous Pemphigoid is considered an autoimmune disease. It can affect a large part of your skin causing distress and discomfort.
Symptoms of Bullous Pemphigoid
The primary symptom of Bullous Pemphigoid is the large blisters. Around the blisters the skin can appear red or normal. Several weeks or months before the blisters appear a person may have a nonspecific itchy red rash. Some people who have Bullous Pemphigoid may not even have any symptoms. General symptoms may include:
- Having a rash that looks like hives
- Sores in your mouth
- Gums that bleed
- Redness of your skin
- A burning sensation of your skin
- A sensitivity to acidic foods if the mucous membranes in your mouth have been affected,
- There are usually multiple blisters which are referred to as bullae.
- The blisters can break open and form open sores or ulcers.
What causes this condition is not really understood but the main cause is a malfunction in your immune system. Normally your immune system produces antibodies to fight off foreign bodies but with Bullous Pemphigoid these antibiotics trigger an inflammatory activity that causes these blisters to form. The proteins, which are necessary for your layers of skin to adhere together are the ones that antibiotics attack. Because of the malfunction in your immune system your body basically turns on the top layers of your skin and starts to attack these layers. Bullous Pemphigoid is usually caused by inflammation and antibodies that are abnormally accumulating in the layer of tissue called basement membrane, It has also been thought that due to different studies that Bullous Pemphigoid is more prevalent in people who have had some type of neurological disease, particularly dementia, Parkinson disease, and strokes.
Factors that can contribute to Bullous Pemphigoid
Bullous Pemphigoid will usually appear with no clear factors but sometimes it can be triggered by medical treatments such as:
- Medications such as prescription drugs Lasix, Enbrel, Azulfidine, and Penicillin
- Radiation and light – some skin conditions are treated with ultraviolet light therapy and cancers treated with radiation may trigger this condition.
- Over-the counter medication such as nonsteroidal anti-flammatory like Ibuprofen.
- An aging immune system in some individuals that become activated because of some genetic predisposition.
- Physical traumas – sun or heat
- Mechanical traumas
There is no cure for Bullous Pemphigoid so the main goal in treatment is to help your skin heal as quickly as it can plus help relieve the itching associated with Bullous it is Pemphigoid. Usually treatment is needed to be done for several years before it is completely cleared up. Once diagnosed with this condition your doctor will prescribe a combination of medications. The purpose of this combination of medications is to help inhibit your immune system activities that are causing the inflammation and itching. Some of these medications may include:
The medication that is commonly prescribed in this classification is prednisone and comes in a pill. There is also a corticosteroid ointment that you can get to rub on the affected areas of your skin. The ointment has fewer side effects than the pill.
These medications will help to inhibit the production of the body’s white blood cells, which are used to fight diseases.
There are a variety of these medications that has an anti-inflammatory property that can be used with corticosteroids or by themselves.
This would help suppress your immune system.
Antibiotics called Tetracycline may be used in cases that are mild. Sometimes along with Tetracycline you may also take a B complex vitamin called Niacin.
Home Remedies and Lifestyle
- Avoid any injuries to the blister areas—the combination of corticosteroid ointment and the blisters make your skin fragile so if you injure the area you could burst the blister.
- If a blister pops make sure that you protect it from infection while it is healing by covering the area with a dressing that is dry and sterile.
- Avoid long exposures to the sun.
- Watch what you are eating, especially if you have any blisters in your mouth. You should avoid any crunchy and hard foods like raw vegetables and fruits because eating these foods could aggravate your symptoms
If it is widespread and treatments done at home do not seem to be working a person may need to be hospitalized in order to have the raw areas and blisters dressed by an expert. If there is a secondary bacterial infection a person may be prescribed antibiotics.
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