What is bullous pemphigoid?

Bullous pemphigoid is a rare autoimmune disease that causes large blisters on the skin. This disease is not contagious and can last for months or even years. Some people only develop itching and a rash, while others only develop blisters. Most people develop blisters on one or more of the following areas: arms, armpits, legs, abdomen, groin, or mouth. Although this disease is uncommon, dermatologists are seeing an increase in cases. There are two possibilities for this:

  • Longer life expectancy. Individuals 60 years and older are more likely to develop this disease.

  • Newer medications used to treat diabetes, cancer, and other diseases may possibly trigger bullous pemphigoid.

Who is at higher risk?

Some individuals are at a greater risk of developing bullous pemphigoid. Your risk increases if you:

  • Are older than 60 years of age

  • Previously had a stroke

  • Have dementia, epilepsy, multiple sclerosis, or Parkinson’s disease

Bullous pemphigoid can be life-threatening, especially for older people who are already in poor health. Widespread blisters can lead to an infection called sepsis, which is a life-threatening condition. Seek medical attention immediately (within 24 hours) if you have a leaking, open blister. Treatment can prevent serious and sometimes life-threatening infections.

What are the signs and symptoms of bullous pemphigoid?

The first sign of the condition is often itching and possibly hive-like reactions. This disease is usually accompanied by a cycle of blisters, but this is not always the case. Despite being a blistering disease, research shows that approximately 20% of people who develop bullous pemphigoid never get blisters. When old blisters heal, new blisters begin to form. Treatment can help prevent or reduce blisters from appearing as well as rashes from developing. As signs and symptoms begin to decrease it goes into remission. Be aware that a disease in remission always carries the possibility of returning.

How is bullous pemphigoid treated?

At Mittal Dermatology we will design a treatment plan based on your individual needs. Treatment will focus on rapid, sustained relief from your symptoms while minimizing risks for adverse effects. You can expect treatment to:

  • Stop (or reduce) new blisters

  • Heal existing blisters and sores

  • Treat infection if developed

  • Relieve any itch and pain

  • Prevent Recurrences

Treatment helps the skin heal and can lead to the remission of bullous pemphigoid. We may prescribe you creams and ointments called corticosteroids. These drugs help heal the skin, prevent new blisters from appearing, and relieve itching. If you have severe bullous pemphigoid, we may prescribe oral, injectable, or infusion based immunosuppressive medications. These medications are powerful and act quickly to control disease. 

The time required to treat bullous pemphigoid depends on the severity of the disease and response to treatment. Most patients follow a treatment regimen for 6 months to 5 years before their disease goes into long-term remission. Many patients can discontinue treatment once the disease reaches long-term remission.