Bullous pemphigoid (BP) is a chronic blistering of the skin. It ranges from mildly itchy welts to severe blisters and infection, and may affect a small area of the body or be widespread. The vast majority of those affected are elderly, but it has been seen at all ages. Some patients with BP have other autoimmune diseases such diabetes and rheumatoid arthritis.
In severe cases, there are multiple blisters, called bullae. The blisters are usually located on the arms, legs, or middle of the body. About one-third of persons with bullous pemphigoid also develop blisters in the mouth. The blisters may break open and form ulcers or open sores.
Treatment is focused on relief of symptoms and prevention of infection. Antibiotics are very useful for mild to moderate disease. They do not work on bacteria, but act directly on the immune system. They can be used in combination with potent topical steroid creams for more rapid relief.
Oral steroids (prednisone, prednisolone) are the treatment of choice for severe cases.
BP is a self-limiting disease that is in most cases eventually completely clears up and the treatment can be stopped. Treatment is usually needed for several years, but generally after a few months it is possible to reduce the dose of medications to reasonably low levels. BP also often has a pattern of remissions and flare-ups.