Bullous pemphigoid is a type of rare and chronic skin disorder that is associated with the eruption of tense blisters on the skin surface particularly that of arms and legs. The condition of bullous pemphigoid, which sometimes involves oral mucous membrane (the inner lining tissues), is considered to be an outcome of abnormal accumulation of antibodies and inflammation on a specific layer of the skin, called "basement membrane."

The binding of these antibodies (immunoglobulins) with proteins in the basement membrane (known as hemidesmosomal pullous pemphigoid antigens) pulls the inflammatory cells.

Symptoms of bullous pemphigoid  

Acute itching, skin rashes, inflammation, mouth sores and bleeding gums are some of the signs of bullous pemphigoid.

Multiple blisters or bullaes (appearing with elevation of the skin filled with serous fluid) can be found in severe cases. Such blisters usually affect the arms, legs and middle part of the body. Blisters in many people with bullous pemphigoid also develop in the mouth. When blisters break open, they lead to formation of ulcers.

The condition of bullous pemphigoid causes pain and burning sensation making the patient sensitive to acidic foods when it affects mucous membranes of the mouth. It also makes eating very difficult. When the condition strikes the deeper area of throat, it leads to coughing. If the inner nose is involved, it will result in nosebleeds.

Who are at the risk?

Bullous pemphigoid can be found in a majority of people aged 50 years or above. Although the exact cause behind this condition is not known, it is believed that it occurs with activation of aging immune system in some genetically predisposed people. Young people are rarely affected by bullous pemphigoid.

Diagnosis of bullous pemphigoid

The diagnosis of bullous pemphigoid depends upon the findings of biopsy about the nature of the tissue involved.

Biopsy helps detect the deposition of any abnormal antibodies in mucous membrane tissue or skin's basement membrane layer.

Sometimes, other conditions such as systemic lupus erythematosus or cancer can be involved in bullous pemphigoid.

When to seek medical advice

You must see a doctor when you notice blisters or itchy rash on your skin. A skin specialist or dermatologist can properly evaluate your condition.

What are the complications?

The medications used in the treatment of bullous pemphigoid can lead to several other complications.

Immunosuppressants, a kind of drug that can be used in the treatment of bullous pemphigoid, can adversely affect the immune system, giving rise to the chances of development of certain infections and cancers. If corticosteroids are taken for a long period, it may case osteoporosis and bone fractures.

Bullous pemphigoid may also worsen the quality of life. You may feel difficulty in eating if blisters develop in your mouth.

It will be difficult for you to perform daily activities if blisters or ruptured blisters appear on your hands and feet. Moreover bullous pemphigoid in your eyes may result in scarring.

Treatment of bullous pemphigoid

The general health of the people with bullous pemphigoid often remains unaffected irrespective of the severity of the disease.

Treatment of bullous pemphigoid entails application of topical cortisone creams. Sometimes high doses of cortisone ("steroids") are required in the treatment. Azathioprine (Imuran), an immune suppression drug is sometimes required in some severe cases of bullous pemphigoid.

Tetracycline remained one of the options for treatment of bullous pemphigoid. The infusion of intravenous immunoglobulin once in a month can be another treatment for severe cases.

According to researchers the application of the large amount of high potency topical corticosteroids to the surface of the whole body can effectively control extensive bullous pemphigoid than compared to oral corticosteroids. The researchers believe that topical corticosteroids can be an alternative for treatment of bullous pemphigoid, especially when it is not extensive.

Prevention

The ways for control and prevention of bullous pemphigoid still remain unknown. However, there are certain drugs that react with development of blisters, which have similarity with that appearing in those with bullous pemphigoid. In case you notice any problem in your skin after you start a medication, you would better consult your doctor.

Home Cures Bullous Pemphigoid

If you are suffering from bullous pemphigoid, you can adopt a variety of measures to take care of your condition. Here are some steps to take care:

Watching your diet: If blisters appear in your mouth, don't eat hard and crunchy foods. You must avoid eating chips, raw fruits and even vegetables as they may create difficulty for you to eat.

Avoid injury: Since bullous pemphigoid or the medication used to treat it already weakens your skin, it is advisable for you to take utmost care of yourself so as to avoid any injury that can worsen your skin condition. If a blister on your skin is accidentally broken, you will need to cover a dry and sterile dressing on it to safeguard it from any possible infection.

Take necessary supplements: The consumption of oral corticosteriods for more than a month may case osteoporosis. Under such circumstances you must consult your doctor to know if you require calcium and vitamin D supplements for prevention of osteoporosis.

Prepare your skin for exposure to sun: Apply sunscreen having 15 SPF (Sun Protection Factor) or more than this, on your skin at least half an hour before venturing out under the Sun.