Not to be confused with Bullous Pemphigus
Aetiology
- Elderly (>65yrs)
- Vaccinations (in children with condition affecting face, palms and soles)
- NSAIDs, furosemide, antibiotics
- UV radiation / x-rays
Pathophysiology
- Autoimmune, subepidermal blistering due to IgG autoantibodies for the basement membrane proteins BP1 and BP2.
- IgG bind to basement membrane and activate inflammatory cascade.
Signs & Symptoms
- Present acutely or insidiously
- Often a pruritic prodromal rash & region
- Thick, tense blisters & erosions appear typically in flexural regions of limb and trunk
- Self limiting @ 2 yrs
- Usually heal without scarring (unless cicatricial pemphigoid involving the mucous membrane)
Management
- Topical if localised, systemic if severe.
- Corticosteroids (prednisolone)
- Immunosuppressants (azathioprine/methotrexate)
References:
- British Association of Dermatologists: Dermatology, a handbook for medical students & junior doctors
- bad.org.uk
- dermnetnz.org