Bullous Pemphigoid Flashcards
What is bullous pemphigoid?
An autoimmune, subepidermal blistering disease
Who gets bullous pemphigoid?
People over 80
Can occur in younger adults, but in children very rare
Is it more common in men or women?
Equal
It is more common in elderly patients with what conditions?
Neurological - especially stroke, dementia, PD
The risk of developing it is greater with what skin condition?
Psoriasis
What can precipitate it?
Treatment of psoriasis with phototherapy
What are some other triggers?
Drugs - PD1 inhibitor immunotherapies used to treat metastatic melanoma and other cancers, gliptins, antibiotics
Injury
Skin infection
What causes bullous pemphigoid?
An attack on the basement membrane of the epidermis by IgG +/- IgE immunoglobulins and activation of T lymphocytes.
What are the clinical features?
Severe itch
Large, tense bullae
Bullae can rupture forming crusted erosions
May have red skin, annular lesions, small blisters, prurigo nodules
Where does it occur?
May be localised to one area or widespread on the trunk and proximal limbs
Frequently affects skin around skin folds
What colour are the blisters?
Clear or cloudy
Yellowish or bloodstained fluid
What complications can occur?
Bacterial infections and sepsis
Viral infection
How is it treated?
Very potent topical steroids
Systemic steroids e.g prednisolone
Tetracycline antibiotics
Pain relief
Is treatment usually needed for several years?
Yes
What are some side effects of systemic steroids?
Gastritis
HTN
DM
Osteoporosis
