Bullous Pemphigoid - Diagnosis and Management Summary

Pathophysiology: Autoantibody-mediated damage to epithelial basement membrane -> separation of epidermis from dermis

Clinical Signs/Symptoms/Exam findings:

 - Prodrome: pruritic, inflammatory plaques (may resemble eczema or urticaria) weeks to months bullous phase

 - Bullous phase: tense 1-3 cm bullae, often pruritic. Most commonly located on trunk, flexural surfaces, and axillary and inguinal folds

 - Erosions and crusts at sites of ruptured bullae

 - Mucous membrane involvement with blisters/erosions in ~20%

Management:

  1. High-potency topical steroids

  2. Systemic glucorticoids if 1) not feasible



CMC IM Residency @CMC_IM



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