Bullous pemphigoid

Question 1

What is bullous pemphigoid?

Answer 1

An autoimmune condition causing subepidermal blistering of the skin

Question 2

What antibodies are responsible for the development of bullous pemphigoid?

Answer 2

Antibodies against hemidesmosomal proteins, BP180 and BP230

Question 3

What are the clinical features of bullous pemphigoid?

Answer 3

• Itchy, tense blisters (typically found around flexures)
• Blisters heal without scarring
• No mucosal involvement

Question 4

What type of hypersensitivity reaction is bullous pemphigoid an example of?

Answer 4

Type II

Question 5

What are the typically findings on skin biopsy in bullous pemphigoid?

Answer 5

Immunofluorescence shows IgG and C3 at the dermo-epidermal junction

Question 6

What is the management of bullous pemphigoid?

Answer 6

• Referral to a dermatologist for biopsy and confirmation of diagnosis
• Oral corticosteroids are the mainstay of treatment
• Topical corticosteroids, immunosuppressants and antibiotics are also used