Bullous pemphigoid (BP) is a skin condition where multiple firm, fluid-filled blisters develop on the body.
Itchy and sometimes painful, these blisters form most commonly in skin folds (below the breasts, groin, and armpits) and trauma-prone areas (hands, arms, and legs). They range in size from the size of a pencil eraser to the size of a tennis ball. When the blisters break open, the skin underneath crusts over and appears raw, with a chance of becoming infected. Sometimes BP can be present as an itchy, hive- or ringworm-like rash without blisters. It is most common in elderly people with neurologic diseases, such as dementia and Parkinson’s disease and in those who have suffered a stroke.
BP is an autoimmune disease in which the body’s own immune system attacks the connecting area between the upper (epidermis) and lower (dermis) layers of the skin. Certain medications, skin injuries, or skin infections can trigger BP, which (in rare cases) may be linked to internal cancers.
Several topical and oral medications are used to treat bullous pemphigoid.
- Topical steroids
- Topical or oral antibiotics (when there is skin infection)
- Oral steroids and systemic immunosuppressive medications (when BP is severe)
- Oral antibiotics, such as tetracycline and doxycycline, and nicotinamide (a form of vitamin B3), for decreasing skin inflammation in BP
Because BP tends to look like other conditions, you should consult a physician, who may perform a skin biopsy to confirm the diagnosis.