Bullous pemphigoid is the appearance of blisters on the skin caused by a disorder of the immune system. Blisters are more common in body folds, such as the armpits, groin, and lower abdomen.
Bullous pemphigoid can affect anyone, especially people over the age of 60. This disease is rare and actually not dangerous. Nevertheless, bullous pemphigoid still needs to be watched out for when it attacks the elderly who are in poor health.
Bullous pemphigoid is an autoimmune disease. This disease causes the immune system, which should function to protect the body, instead produces antibodies to attack healthy tissue in the body itself.
The tissue that is attacked is skin tissue, resulting in inflammation that causes the outermost layer of skin (epidermis) to separate from the layer of skin below it (dermis) and blisters appear.
It is not known exactly why the body's immune system attacks the skin's own tissue, but there are several things that can trigger this disease:
- Taking certain drugs
For example, penicillin sulfasalazine, furosemide, and etanercept.
- Sufferdisease certain
For example diabetes, arthritis, psoriasis, ulcerative colitis, lichen planus, epilepsy, stroke, dementia, Parkinson's disease, and multiple sclerosis.
- Special therapyFor example radiotherapy to treat cancer and ultraviolet light therapy to treat psoriasis.
Symptoms of Bullous Pemphigoid
The initial symptoms of bullous pemphigoid are changes in skin color to redness or blackness, and itching. This skin disorder is more often formed in the folds, such as the armpits, groin, or abdomen.
After a few weeks or months, on the surface of the skin, blisters appear that contain clear fluid or fluid mixed with blood. These blisters don't tear easily just by touch. If the blisters tear or burst, they will be painful, but will not scar. This symptom is often thought of as wet eczema.
When to go to the doctor
Although harmless, bullous pemphigoid still needs to be treated. You can consult a doctor if suddenly blisters appear on the skin. This is especially true if the blisters are accompanied by:
- Signs of infection, such as fever and purulent skin.
- Blisters appear on mucous membranes, such as inside the mouth, nose, or eyelids.
Diagnosis of Bullous Pemphigoid
After asking about symptoms and examining the condition of the blistered skin, the doctor will perform additional tests to confirm that the patient has bullous pemphigoid.
The doctor will take some of the patient's skin tissue in the blister for examination in the laboratory (skin biopsy). In addition to a biopsy, a blood test may also be done to detect antibodies.
Bullous Pemphigoid Treatment
Treatment for bullous pemphigoid focuses on eliminating skin blisters, relieving itching, and preventing new blisters from forming. Listed below are some of the types of medicines used to treat bullous pemphigoid:
Corticosteroid class of drugs
This drug will reduce inflammation by inhibiting the immune system. Corticosteroid drugs are available in the form of ointments and tablets. Corticosteroid ointment has fewer side effects than tablet corticosteroids, because it is only applied to the surface of the skin.
Long-term use of corticosteroid tablets can increase the risk of diabetes, high blood pressure, high cholesterol, brittle bones (osteoporosis), and infections.
Therefore, the doctor will immediately stop the treatment gradually when the skin blisters are gone. Discuss with a dermatologist about the benefits and risks of corticosteroid drugs, if these drugs need to be taken for more than 2 weeks. Examples of corticosteroid drugs are: methylprednisolone.
Immunosuppressive drugs
Similar to corticosteroids, these drugs suppress the immune system. Immunosuppressive drugs are given so that the dose of corticosteroid drugs can be reduced, to avoid the side effects of corticosteroids. Some examples of immunosuppressive drugs are: mycophenolate mofetil, methotrexate, rituximab, and azathioprine.
Ointment antibiotics
If there is an infection in the blisters or there is a risk of infection in the layers of the skin, for example if the blisters have ruptured and blistered, the doctor will prescribe an antibiotic ointment. Examples of antibiotic ointments given are: tetracycline hydrochloride.
In addition to using the drugs above, people with bullous pemphigoid can take the following steps to prevent the blisters from getting worse:
- Avoid sun exposure.
- Wear loose-fitting clothing to reduce skin irritation.
- Bath with soap for sensitive skin (mild soap) and use a moisturizer after bathing.
- Avoid eating hard or crunchy foods, such as crackers or chips, if you have blisters in your mouth.
- Reduce activities that involve the body part with the blister.
Although the drugs given only reduce the symptoms that appear and there is no cure for bullous pemphigoid, people with this disease will recover on their own within a few months to five years, and do not recur.
