Cause of the disease

Bullouspemphigoid results in the appearance of large, tense blisters on an erythematous and oedematous base, but also on skin that does not appear to be affected. Lesions may also appear on mucous membranes. The cause of the lesions is the presence of so-called autoantibodies in the patient's serum, which are directed against basement membrane antigens. The bas ement membrane is the element that connects the dermis to the epidermis. When the antibodies bind to the antigen, a reaction occurs, resulting in the separation of the epidermis from the dermis layer of the skin, which results in blistering. The disease is among the most common subepidermal autoimmune diseases diagnosed in people over 65 years of age.

Pemphigoid and tumours

Pemphigoid can be one of the symptoms of cancer. Pemphigoid has been diagnosed in patients suffering from lung, pancreatic, breast, urinary or gastrointestinal cancers. Once the cancer has been removed, such as after surgery and chemotherapy, the skin lesions disappear.

Blisters and medication

Some of the drugs used orally, e.g. those containing furosemide, phenacetin, penicillin, non-steroidal anti-inflammatory drugs (NSAIDs), cephalosporins or topical preparations (used in the treatment of scabies or psoriasis, e.g. 5-fluorouracil, salicylic acid) may also cause the appearance of bullous pemphigoid. Discontinuation of the drugs usually results in regression of the skin lesions.

Symptoms of the disease

The most commonly diagnosed symptoms include swollen or urticarial erythema, blisters containing serous or bloody contents. Blisters can appear all over the body, but are most commonly seen on the trunk, flexions of the limbs and mucous membranes.

What should be done when changes are observed?

In the current outbreak situation, contact your GP by telephone or video chat. The doctor will decide on an office visit and its timing. Confirmation of the disease is by careful analysis of the blisters, their appearance and location. A histopathological examination combined with a serum immunological test for specific antibodies is necessary. Once the results have been assessed, the doctor is able to make a diagnosis.

Treatment options

Treatment depends on the age and condition of the patient. The most common treatment is topical - blisters are washed and external glucocorticosteroid medication is applied. If treatment is unsuccessful, the dermatologist may recommend oral glucocorticosteroids, e.g. combined with sulfonylureas or antibiotics. In case of resistant lesions, immunosuppressive treatment is used after excluding the coexistence of cancer. The disease is treatable, but the patient - even after treatment - must be under the care of a dermatology clinic.