Bullous pemphigoid: Difference between revisions
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==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Cicatricial Pemphigoid | *Cicatricial Pemphigoid | ||
*Dermatitis Herpetiformis | *Dermatitis Herpetiformis | ||
*Drug-Induced Bullous Disorders | *Drug-Induced Bullous Disorders | ||
*[[Erythema Multiforme]] | *[[Erythema Multiforme]] | ||
==Management== | ==Management== | ||
Revision as of 22:38, 24 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 (eg, corticosteroids, tetracyclines, dapsone)
- Immunosuppressants (eg, azathioprine, methotrexate, mycophenolate mofetil, cyclophosphamide).
- European article: evidence that strong topical corticosteroid treatment may achieve disease control while avoiding systemic adverse effects from systemic corticosteroids[2][3][4]
- Derm referral for dx via biopsy
Sources
- Medscape: http://emedicine.medscape.com/article/1062391-overview - last accessed Jan 2015
- 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].
- 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].
See Also
- ↑ 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].