Bullous pemphigoid: Difference between revisions
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==Management== | ==Management== | ||
*''' | *'''Antihistamine''' for pruritis | ||
*'''Anti-inflammatory''' agents options | *'''Anti-inflammatory''' agents options | ||
**Oral Corticosteroids such as Prednisone 50mg PO daily | **Oral Corticosteroids such as Prednisone 50mg PO daily | ||
Revision as of 15:08, 25 January 2015
Background
- Chronic autoimmune blistering disease
- Typically older than 60 years of age
- Blisters occur deep, within the epidermal basement membrane,
- Bullae evolve over weeks to months
Clinical Presentation
- Bullae commonly occur in the axillae, abdomen, inner thighs, flexural forearms, and lower legs[1]
- May be intensely pruritic
- Nikolsky sign negative
- No mucous membrane involvemet
Differential Diagnosis
- Cicatricial Pemphigoid
- Dermatitis Herpetiformis
- Drug-Induced Bullous Disorders
- Erythema Multiforme
Management
- Antihistamine for pruritis
- Anti-inflammatory agents options
- Oral Corticosteroids such as Prednisone 50mg PO daily
- Tetracycline 1.5-2 g/day with Nicotinamide 1.5-2 g/day
- Topical high potency steroids such as Clobetasol
- Immunosuppressants (eg, azathioprine, methotrexate, mycophenolate mofetil, cyclophosphamide).
Topical corticosteroids may offer similar treatment effect as oral steroids with less systemic effects.[2][3][4]
- Derm referral for dx via biopsy
Sources
- ↑ http://emedicine.medscape.com/article/1062391-overview
- ↑ Joly P, Roujeau JC, Benichou J, et al. A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med. Jan 31 2002;346(5):321-7. [Medline].
- ↑ Terra JB, Potze WJ, Jonkman MF. Whole body application of a potent topical corticosteroid for bullous pemphigoid. J Eur Acad Dermatol Venereol. Apr 3 2013;[Medline].
- ↑ 2. Gual A, Iranzo P, Mascaró Jr JM. Treatment of bullous pemphigoid with low-dose oral cyclophosphamide: a case series of 20 patients. J Eur Acad Dermatol Venereol. Apr 13 2013;[Medline].