Materiały źródłowe

• #1 Bullous Pemphigoid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535374/

  Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disorder, representing 80% of subepidermal immunobullous cases. It most commonly affects elderly patients between the ages of 60 and 80. This activity reviews the etiology, presentation, evaluation, and management of bullous pemphigoid and the interprofessional team’s role in evaluating, diagnosing, and managing the condition. […] Treatment depends on the severity of the disease; however, standard therapies involve topical or systemic immunosuppressive agents. […] The mainstay of treatment for bullous pemphigoid is systemic corticosteroids, but treatment ultimately depends on comorbidities and the extent of the disease. For localized disease, less than 20% of body surface area in an elderly patient, super-potent topical steroids such as clobetasol may be used.

• #2 Bullous pemphigoid

  https://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1

  Bullous pemphigoid commonly starts with itching and fixed urticarial-like lesions or occasionally an eczematous rash, which predominantly affects the limbs. […] The vast majority of patients need urgent referral to Secondary Care, and those with widespread blistering may require admission. A few patients, eg those with localised disease, may be suitable for management in Primary Care. […] Supportive measures include wound care and reducing the risk of secondary infection by using antiseptic regimes, eg Dermol 500 lotion as a wash and / or topical emollient. […] Dermovate cream (clobetasol) is a very effective treatment for localised disease. It can also be tried BD in more extensive disease, as the side effects are very much less then when compared to systemic steroids. […] Systemic steroids are the mainstay of treatment. The initial dose is as follows: 20 mg / day in localised-mild disease, 40 mg / day in moderate disease, 50-70 mg / day in severe disease. […] In addition to providing gastric protection with a PPI, treatment to help prevent osteoporosis should be initiated at an early stage.

• #3 Bullous Pemphigoid: Clinical Practice Guidelines | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-bullous-pemphigoid-clinical-practice-guidelines-articulo-S1578219014000778

  Bullous pemphigoid (BP) is an autoimmune blistering disorder characterized by the formation of autoantibodies directed against components of the basement membrane. Most of these antibodies belong to the immunoglobulin (Ig) G class and bind primarily to 2 hemidesmosomal proteins: the 180-kD antigen (BP180) and the 230-kD antigen (BP230). There is experimental and clinical evidence that these autoantibodies and particularly those targeting BP180 are responsible for causing the blisters and therefore the disease. […] In practice, the choice of treatment and general management of the disease will largely depend on the patient. Several considerations need to be taken into account when dealing with special populations, such as elderly patients or children. […] Elderly patients tend to have age-related immune system impairment and comorbidities and therefore the recommendation to avoid immunosuppressive drugs is even more important in this group of patients.

• #4 Bullous pemphigoid

  https://www.nhs.uk/conditions/bullous-pemphigoid/

  Bullous pemphigoid eventually goes away on its own. […] Treatment can help your skin heal, stop new patches or blisters appearing, and lower the chances of your skin getting infected. […] Do not burst your blisters yourself unless you have been shown how to by a nurse. Your skin might get infected. […] It’s important to go to check-ups with your doctor so problems can be found and treated early.

• #5 Bullous pemphigoid

  https://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1

  Bullous pemphigoid commonly starts with itching and fixed urticarial-like lesions or occasionally an eczematous rash, which predominantly affects the limbs. […] The vast majority of patients need urgent referral to Secondary Care, and those with widespread blistering may require admission. A few patients, eg those with localised disease, may be suitable for management in Primary Care. […] Supportive measures include wound care and reducing the risk of secondary infection by using antiseptic regimes, eg Dermol 500 lotion as a wash and / or topical emollient. […] Dermovate cream (clobetasol) is a very effective treatment for localised disease. It can also be tried BD in more extensive disease, as the side effects are very much less then when compared to systemic steroids. […] Systemic steroids are the mainstay of treatment. The initial dose is as follows: 20 mg / day in localised-mild disease, 40 mg / day in moderate disease, 50-70 mg / day in severe disease. […] In addition to providing gastric protection with a PPI, treatment to help prevent osteoporosis should be initiated at an early stage.

• #6 Bullous Pemphigoid Nursing Care Plan – Planning for Care

  https://planningforcare.co.uk/product/bullous-pemphigoid/

  Bullous Pemphigoid Nursing Care Plan […] Bullous Pemphigoid is an autoimmune disease, which causes the skin to blister. The blisters can be large, measuring up to 3cm across, and may be itchy and painful, they appear mainly on the trunk, arms, and legs. Occasionally, the inner lining tissue of the mouth, mucous membrane tissue, can be involved. […] This condition is not infectious. The majority of cases of Bullous Pemphigoid occur in people 50 years of age or older. The condition can resolve with topical cortisone creams but sometimes requires high doses of steroids taken internally. Severe Bullous Pemphigoid can also require immune-suppression drugs. […] This care plan sets out a clear explanation of the resident’s issue, and will quickly guide the nurse or carer through the process of preparing a comprehensive, individual person centred Care Plan. […] Nursing Care Plan Features: […] Identifies the symptoms experienced […] Identifies the effects the condition has on the resident […] Details a comprehensive plan of care

• #7 Bullous pemphigoid – General Nursing Support

  https://allnurses.com/bullous-pemphigoid-t64234/?do=findComment&comment=595684

  Have any of you guys taken care of anyone with a disorder named bullous pemphigoid? It is horrible! CNAs are asking if what this person has is contageous and if it is going to kill this resident. This resident has huge blisters, some filled with blood and some with viscous fluid. They grow large then burst, leaving flattened scars that are becoming infected. She stays up all night just scratchng and scratching. We have mitts on her, but she scratches with the mitts. […] I don’t have any suggestions to offer. I have seen one patient with this and it is indeed horrid to witness. Same scenerio as yours, we had to put mittens on and wrap her arms with rolls of gauze to keep her from scratching. We treated her as you said, with steriods. […] Yes, I have seen a few patients with it. As far as I remember, it is not contagious. It looks terrible though! I think it is auto immune disorder.

• #8 Bullous pemphigoid – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bullous-pemphigoid/diagnosis-treatment/drc-20350419

  Your healthcare professional will talk with you about your symptoms and medical history and conduct a physical exam. You may need tests to confirm a diagnosis of bullous pemphigoid. These may include blood tests, a skin biopsy or both. A biopsy is a procedure to remove a sample of tissue for testing in a lab. […] Treatment of bullous pemphigoid is aimed at healing the skin, relieving itching and pain, and preventing new blisters. Your healthcare professional will likely prescribe one or a combination of medicines: […] Follow your healthcare professional’s advice for care of blisters. […] Blisters on the feet and hands can make it difficult to walk or to go about daily tasks. The itching may make it hard to sleep. You may need to change your routine until the blisters are under control.

• #9 Autoimmune Bullous Dermatoses: A Review | AAFP

  https://www.aafp.org/pubs/afp/issues/2002/0501/p1861.html

  The involvement of mucous membranes is much less common with bullous pemphigoid than in pemphigus vulgaris, with blisters that are less easily ruptured. Sites involved include the oral cavity, anus, and genital mucosa. […] Histologic examination of a skin biopsy from a bulla reveals a subepidermal blister with superficial dermal inflammation consisting of lymphocytes, histiocytes, and eosinophils. Urticarial lesions may also be accompanied by papillary dermal edema. […] On electron microscopy, blister formation is found to occur within the lamina lucida of the basement membrane, causing a loss of anchoring filaments and hemidesmosomes. Direct immunofluorescence reveals deposition of IgG, and possibly C3, along the basement membrane zone in a linear pattern. […] Treatment consists of systemic prednisone, alone or in combination with a steroid-sparing agent such as azathioprine, mycophenolate mofetil or a tetracycline. These drugs are usually started simultaneously, followed by a gradual tapering of the prednisone and continuation of the steroid-sparing agent until clinical remission is achieved. Mild cases may require only topical corticosteroids. Methotrexate may be used in patients with severe disease who are unable to tolerate prednisone. […] Bullous pemphigus is a self-limited disease, but may last from months to years. It is rarely fatal, and even without corticosteroid therapy, carries a good prognosis. Approximately one half of treated cases will remit within six years.

• #10 Bullous pemphigoid – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bullous-pemphigoid/diagnosis-treatment/drc-20350419

  Your healthcare professional will talk with you about your symptoms and medical history and conduct a physical exam. You may need tests to confirm a diagnosis of bullous pemphigoid. These may include blood tests, a skin biopsy or both. A biopsy is a procedure to remove a sample of tissue for testing in a lab. […] Treatment of bullous pemphigoid is aimed at healing the skin, relieving itching and pain, and preventing new blisters. Your healthcare professional will likely prescribe one or a combination of medicines: […] Follow your healthcare professional’s advice for care of blisters. […] Blisters on the feet and hands can make it difficult to walk or to go about daily tasks. The itching may make it hard to sleep. You may need to change your routine until the blisters are under control.

• #11 Bullous Pemphigoid Treatment & Management: Medical Care, Complications, Diet

  https://emedicine.medscape.com/article/1062391-treatment

  As in other autoimmune bullous diseases, the general aims of therapy are to decrease blister formation, to promote healing of blisters and erosions, and to determine the minimal dose of medication necessary to control the disease process. Therapy must be individualized for each patient, keeping in mind preexisting conditions and other patient-specific factors. […] Proper treatment of bullous pemphigoid depends on the severity of the disease. For localized disease, a topical steroid plus a systemic anti-inflammatory (eg, tetracycline or nicotinamide) may be sufficient. The effects of monotherapy with nicotinamide are unknown. For more severe cases, systemic steroids along with immunosuppressants may be needed for control. […] Patients should be instructed to avoid direct physical trauma to their skin surfaces.

• #12 Bullous pemphigoid

  https://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1

  Bullous pemphigoid commonly starts with itching and fixed urticarial-like lesions or occasionally an eczematous rash, which predominantly affects the limbs. […] The vast majority of patients need urgent referral to Secondary Care, and those with widespread blistering may require admission. A few patients, eg those with localised disease, may be suitable for management in Primary Care. […] Supportive measures include wound care and reducing the risk of secondary infection by using antiseptic regimes, eg Dermol 500 lotion as a wash and / or topical emollient. […] Dermovate cream (clobetasol) is a very effective treatment for localised disease. It can also be tried BD in more extensive disease, as the side effects are very much less then when compared to systemic steroids. […] Systemic steroids are the mainstay of treatment. The initial dose is as follows: 20 mg / day in localised-mild disease, 40 mg / day in moderate disease, 50-70 mg / day in severe disease. […] In addition to providing gastric protection with a PPI, treatment to help prevent osteoporosis should be initiated at an early stage.

• #13 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  For mild cases of bullous pemphigoid, the best treatments are topical corticosteroid creams or ointments that you rub directly on the affected areas. […] For moderate-to-severe cases of bullous pemphigoid, your healthcare provider may prescribe an oral corticosteroid, like prednisone, in addition to a steroid-sparing immunomodulatory agent such as dapsone, mycophenolate mofetil, azathioprine, methotrexate or chlorambucil. […] If you cant take cant corticosteroids or other immunomodulatory agents, your healthcare provider may prescribe oral tetracycline or doxycycline pills. […] For refractory cases of bullous pemphigoid, your healthcare provider may prescribe rituximab or IVIG infusions. […] There arent any home remedies for bullous pemphigoid, but there are things you can do to make your symptoms more tolerable, including: Wear soft, loose-fitting clothing made out of natural fibers.

• #14 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  For mild cases of bullous pemphigoid, the best treatments are topical corticosteroid creams or ointments that you rub directly on the affected areas. […] For moderate-to-severe cases of bullous pemphigoid, your healthcare provider may prescribe an oral corticosteroid, like prednisone, in addition to a steroid-sparing immunomodulatory agent such as dapsone, mycophenolate mofetil, azathioprine, methotrexate or chlorambucil. […] If you cant take cant corticosteroids or other immunomodulatory agents, your healthcare provider may prescribe oral tetracycline or doxycycline pills. […] For refractory cases of bullous pemphigoid, your healthcare provider may prescribe rituximab or IVIG infusions. […] There arent any home remedies for bullous pemphigoid, but there are things you can do to make your symptoms more tolerable, including: Wear soft, loose-fitting clothing made out of natural fibers.

• #15 Bullous Pemphigoid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535374/

  Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disorder, representing 80% of subepidermal immunobullous cases. It most commonly affects elderly patients between the ages of 60 and 80. This activity reviews the etiology, presentation, evaluation, and management of bullous pemphigoid and the interprofessional team’s role in evaluating, diagnosing, and managing the condition. […] Treatment depends on the severity of the disease; however, standard therapies involve topical or systemic immunosuppressive agents. […] The mainstay of treatment for bullous pemphigoid is systemic corticosteroids, but treatment ultimately depends on comorbidities and the extent of the disease. For localized disease, less than 20% of body surface area in an elderly patient, super-potent topical steroids such as clobetasol may be used.

• #16 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  For mild cases of bullous pemphigoid, the best treatments are topical corticosteroid creams or ointments that you rub directly on the affected areas. […] For moderate-to-severe cases of bullous pemphigoid, your healthcare provider may prescribe an oral corticosteroid, like prednisone, in addition to a steroid-sparing immunomodulatory agent such as dapsone, mycophenolate mofetil, azathioprine, methotrexate or chlorambucil. […] If you cant take cant corticosteroids or other immunomodulatory agents, your healthcare provider may prescribe oral tetracycline or doxycycline pills. […] For refractory cases of bullous pemphigoid, your healthcare provider may prescribe rituximab or IVIG infusions. […] There arent any home remedies for bullous pemphigoid, but there are things you can do to make your symptoms more tolerable, including: Wear soft, loose-fitting clothing made out of natural fibers.

• #17 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  For mild cases of bullous pemphigoid, the best treatments are topical corticosteroid creams or ointments that you rub directly on the affected areas. […] For moderate-to-severe cases of bullous pemphigoid, your healthcare provider may prescribe an oral corticosteroid, like prednisone, in addition to a steroid-sparing immunomodulatory agent such as dapsone, mycophenolate mofetil, azathioprine, methotrexate or chlorambucil. […] If you cant take cant corticosteroids or other immunomodulatory agents, your healthcare provider may prescribe oral tetracycline or doxycycline pills. […] For refractory cases of bullous pemphigoid, your healthcare provider may prescribe rituximab or IVIG infusions. […] There arent any home remedies for bullous pemphigoid, but there are things you can do to make your symptoms more tolerable, including: Wear soft, loose-fitting clothing made out of natural fibers.

• #18 Bullous pemphigoid

  https://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1

  Bullous pemphigoid commonly starts with itching and fixed urticarial-like lesions or occasionally an eczematous rash, which predominantly affects the limbs. […] The vast majority of patients need urgent referral to Secondary Care, and those with widespread blistering may require admission. A few patients, eg those with localised disease, may be suitable for management in Primary Care. […] Supportive measures include wound care and reducing the risk of secondary infection by using antiseptic regimes, eg Dermol 500 lotion as a wash and / or topical emollient. […] Dermovate cream (clobetasol) is a very effective treatment for localised disease. It can also be tried BD in more extensive disease, as the side effects are very much less then when compared to systemic steroids. […] Systemic steroids are the mainstay of treatment. The initial dose is as follows: 20 mg / day in localised-mild disease, 40 mg / day in moderate disease, 50-70 mg / day in severe disease. […] In addition to providing gastric protection with a PPI, treatment to help prevent osteoporosis should be initiated at an early stage.

• #19 Bullous pemphigoid

  https://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1

  Bullous pemphigoid commonly starts with itching and fixed urticarial-like lesions or occasionally an eczematous rash, which predominantly affects the limbs. […] The vast majority of patients need urgent referral to Secondary Care, and those with widespread blistering may require admission. A few patients, eg those with localised disease, may be suitable for management in Primary Care. […] Supportive measures include wound care and reducing the risk of secondary infection by using antiseptic regimes, eg Dermol 500 lotion as a wash and / or topical emollient. […] Dermovate cream (clobetasol) is a very effective treatment for localised disease. It can also be tried BD in more extensive disease, as the side effects are very much less then when compared to systemic steroids. […] Systemic steroids are the mainstay of treatment. The initial dose is as follows: 20 mg / day in localised-mild disease, 40 mg / day in moderate disease, 50-70 mg / day in severe disease. […] In addition to providing gastric protection with a PPI, treatment to help prevent osteoporosis should be initiated at an early stage.

• #20 Bullous Pemphigoid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535374/

  Immunosuppressive therapy is used when steroids do not control the disease or if patients have contraindications for systemic corticosteroid treatments. […] This disease can render the patient’s skin fragile and susceptible to microbial invasion. Patients need to avoid trauma to their skin. Skin hygiene is a crucial component of preventing complications, and patients need to recognize both complications and adverse events from treatment so they can report these to their clinicians. […] Most general practitioners and primary care providers may not be familiar with bullous pemphigoid. This is a serious skin disorder with a very high morbidity and mortality rate. When patients present with large bullae, it is important to seek a dermatology consultation. The sooner the disorder is treated, the better the prognosis.

• #21 Bullous pemphigoid: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-treatment

  Patients with widespread blisters may be admitted to a hospitals burn unit. A burn unit provides the right environment, temperature, and humidity, along with the expertise needed to care for widespread blisters. […] Treatment can prevent a serious and sometimes life-threatening infection. […] A personalized treatment plan usually includes medication and wound care. […] Treatment can help heal your skin so that bullous pemphigoid goes into remission. […] Wound care can prevent infection, relieve pain, and speed up healing. […] Your dermatologist will create a wound care plan that meets your individual needs. Most wound care involves daily cleaning of the wounds, applying medication, and bandaging. When necessary, your dermatologist may refer you to a wound care specialist. […] Following a self-care plan for bullous pemphigoid can improve the results you get from treatment and how well you feel.

• #22 Bullous pemphigoid: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-treatment

  Patients with widespread blisters may be admitted to a hospitals burn unit. A burn unit provides the right environment, temperature, and humidity, along with the expertise needed to care for widespread blisters. […] Treatment can prevent a serious and sometimes life-threatening infection. […] A personalized treatment plan usually includes medication and wound care. […] Treatment can help heal your skin so that bullous pemphigoid goes into remission. […] Wound care can prevent infection, relieve pain, and speed up healing. […] Your dermatologist will create a wound care plan that meets your individual needs. Most wound care involves daily cleaning of the wounds, applying medication, and bandaging. When necessary, your dermatologist may refer you to a wound care specialist. […] Following a self-care plan for bullous pemphigoid can improve the results you get from treatment and how well you feel.

• #23 Bullous Pemphigoid: Clinical Practice Guidelines | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-bullous-pemphigoid-clinical-practice-guidelines-articulo-S1578219014000778

  Good skin hygiene with thorough daily cleansing of skin and mucous membranes is important in all patients with BP. We also recommend keeping an approximate count of lesions. The lesions should be cleansed before the application of the topical treatment. Blisters can be drained by piercing the base of the lesion with a sterile needle or blade. Application of an antiseptic solution, such as eosin 2% or chlorhexidine 0.5%, on erosive lesions reduces the risk of secondary infection. If such an infection does occur, topical antibiotics such as fusidic acid and mupirocin can be used. A course of systemic antibiotics must be started when deep cutaneous infection (cellulitis) is suspected. […] Until recently, treatment decisions in BP were guided by clinical assessment. Unless contraindicated, systemic corticosteroids are generally the treatment of choice in patients in whom topical treatment is insufficient or difficult to apply. In most cases, they produce clinical improvement within a few weeks, enabling a gradual reduction in dosage and in many cases withdrawal after 6 to 10 months. […] In our experience, apart from clinical evaluation, selective quantification of circulating anti-BP180 antibodies by ELISA is a useful tool for monitoring patients, as antibody levels are correlated with disease activity and can facilitate more accurate treatment decisions.

• #24 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Wear loose-fitting cotton clothing. This will reduce rubbing, which could irritate your skin. […] Limit your activities until the blisters are under control. This means no contact sports, swimming, or heavy household chores. If you have blisters on your feet, limit walking. […] Only pop or drain a blister if your dermatologist tells you to do so. When your dermatologist recommends draining a blister, you will receive instructions on how to do this safely. Without these safety precautions, you could cause a serious, and possibly life-threatening, infection. […] If you have germs on your hands and then touch a blister or skin where a blister just ruptured, you can develop an infection. Washing with soap and water helps to remove germs from your hands. […] Blisters and open skin can easily become infected. Its important to watch for these warning signs of infection on your skin:

• #25 Bullous Pemphigoid: Clinical Practice Guidelines | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-bullous-pemphigoid-clinical-practice-guidelines-articulo-S1578219014000778

  Good skin hygiene with thorough daily cleansing of skin and mucous membranes is important in all patients with BP. We also recommend keeping an approximate count of lesions. The lesions should be cleansed before the application of the topical treatment. Blisters can be drained by piercing the base of the lesion with a sterile needle or blade. Application of an antiseptic solution, such as eosin 2% or chlorhexidine 0.5%, on erosive lesions reduces the risk of secondary infection. If such an infection does occur, topical antibiotics such as fusidic acid and mupirocin can be used. A course of systemic antibiotics must be started when deep cutaneous infection (cellulitis) is suspected. […] Until recently, treatment decisions in BP were guided by clinical assessment. Unless contraindicated, systemic corticosteroids are generally the treatment of choice in patients in whom topical treatment is insufficient or difficult to apply. In most cases, they produce clinical improvement within a few weeks, enabling a gradual reduction in dosage and in many cases withdrawal after 6 to 10 months. […] In our experience, apart from clinical evaluation, selective quantification of circulating anti-BP180 antibodies by ELISA is a useful tool for monitoring patients, as antibody levels are correlated with disease activity and can facilitate more accurate treatment decisions.

• #26 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  Wash your sores or ulcers with antibacterial soap and water to prevent infection. Then, apply antibiotic ointment to your affected areas and wrap them in nonadhesive (doesnt stick to your skin) bandages. […] If you have bullous pemphigoid in your mouth, the following tips can make your symptoms more tolerable and help prevent nutrition problems: Eat a diet of soft foods, such as soups, mashed foods, pudding and applesauce. […] Avoid crunchy or sharp foods, including chips, cereal, crusty bread and raw vegetables and fruits. […] Avoid drinking alcohol. […] You should start to feel better a few days after starting treatment.

• #27 Bullous Pemphigoid: Clinical Practice Guidelines | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-bullous-pemphigoid-clinical-practice-guidelines-articulo-S1578219014000778

  Good skin hygiene with thorough daily cleansing of skin and mucous membranes is important in all patients with BP. We also recommend keeping an approximate count of lesions. The lesions should be cleansed before the application of the topical treatment. Blisters can be drained by piercing the base of the lesion with a sterile needle or blade. Application of an antiseptic solution, such as eosin 2% or chlorhexidine 0.5%, on erosive lesions reduces the risk of secondary infection. If such an infection does occur, topical antibiotics such as fusidic acid and mupirocin can be used. A course of systemic antibiotics must be started when deep cutaneous infection (cellulitis) is suspected. […] Until recently, treatment decisions in BP were guided by clinical assessment. Unless contraindicated, systemic corticosteroids are generally the treatment of choice in patients in whom topical treatment is insufficient or difficult to apply. In most cases, they produce clinical improvement within a few weeks, enabling a gradual reduction in dosage and in many cases withdrawal after 6 to 10 months. […] In our experience, apart from clinical evaluation, selective quantification of circulating anti-BP180 antibodies by ELISA is a useful tool for monitoring patients, as antibody levels are correlated with disease activity and can facilitate more accurate treatment decisions.

• #28 Bullous Pemphigoid: Clinical Practice Guidelines | Actas Dermo-Sifiliográficas

  https://www.actasdermo.org/en-bullous-pemphigoid-clinical-practice-guidelines-articulo-S1578219014000778

  Good skin hygiene with thorough daily cleansing of skin and mucous membranes is important in all patients with BP. We also recommend keeping an approximate count of lesions. The lesions should be cleansed before the application of the topical treatment. Blisters can be drained by piercing the base of the lesion with a sterile needle or blade. Application of an antiseptic solution, such as eosin 2% or chlorhexidine 0.5%, on erosive lesions reduces the risk of secondary infection. If such an infection does occur, topical antibiotics such as fusidic acid and mupirocin can be used. A course of systemic antibiotics must be started when deep cutaneous infection (cellulitis) is suspected. […] Until recently, treatment decisions in BP were guided by clinical assessment. Unless contraindicated, systemic corticosteroids are generally the treatment of choice in patients in whom topical treatment is insufficient or difficult to apply. In most cases, they produce clinical improvement within a few weeks, enabling a gradual reduction in dosage and in many cases withdrawal after 6 to 10 months. […] In our experience, apart from clinical evaluation, selective quantification of circulating anti-BP180 antibodies by ELISA is a useful tool for monitoring patients, as antibody levels are correlated with disease activity and can facilitate more accurate treatment decisions.

• #29 Bullous pemphigoid: Diagnosis and treatment

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-treatment

  Patients with widespread blisters may be admitted to a hospitals burn unit. A burn unit provides the right environment, temperature, and humidity, along with the expertise needed to care for widespread blisters. […] Treatment can prevent a serious and sometimes life-threatening infection. […] A personalized treatment plan usually includes medication and wound care. […] Treatment can help heal your skin so that bullous pemphigoid goes into remission. […] Wound care can prevent infection, relieve pain, and speed up healing. […] Your dermatologist will create a wound care plan that meets your individual needs. Most wound care involves daily cleaning of the wounds, applying medication, and bandaging. When necessary, your dermatologist may refer you to a wound care specialist. […] Following a self-care plan for bullous pemphigoid can improve the results you get from treatment and how well you feel.

• #30 Bullous Pemphigoid: Know the Facts

  https://www.webmd.com/skin-problems-and-treatments/what-is-bullous-pemphigoid

  If the blisters are widespread and severe enough, you might need specialized wound care in a hospital burn unit, where the staff has special expertise in wound care. […] It can take several years for bullous pemphigoid to go away completely. In the meantime, your doctor will monitor your progress to see how the treatment is working, and may switch drugs if needed. Some medications can have serious side effects, so report anything unusual to your doctor. You might need regular tests, like a bone density (DEXA) scan, blood pressure monitoring, or blood tests to make sure that you arent having any hidden side effects. […] If your doctor prescribes treatment to manage the blisters and other bullous pemphigoid symptoms, it can take a while before you see or feel any changes. In the meantime, there are some things that you can try at home to help your skin feel at least a bit better:

• #31 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Taking good care of yourself at home may help blisters caused by bullous pemphigoid to clear more quickly. Good care can also prevent a serious infection. Heres what dermatologists recommend for their patients who have bullous pemphigoid. […] Bullous pemphigoid makes skin fragile. To help you get the best results from treatment, dermatologists recommend that you: […] Try not to scratch. When you scratch, you can injure your skin. […] Relieve an area of itchy skin with a cool compress. To make a cool compress, run a clean washcloth under cold water and wring out the washcloth so that water doesnt drip. Then apply your cool compress to the itchy skin and leave it there for 10 to 20 minutes. […] Protect your skin from the sun. If sunlight hits skin with blisters, sores, or rashes, this can be painful. If you need to be outdoors in the sun, protect your skin by seeking shade, wearing sun-protective clothing, and applying sunscreen that offers broad-spectrum protection, water-resistance, and an SPF of 30 or higher. Apply your sunscreen to all skin not covered by clothing.

• #32 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Taking good care of yourself at home may help blisters caused by bullous pemphigoid to clear more quickly. Good care can also prevent a serious infection. Heres what dermatologists recommend for their patients who have bullous pemphigoid. […] Bullous pemphigoid makes skin fragile. To help you get the best results from treatment, dermatologists recommend that you: […] Try not to scratch. When you scratch, you can injure your skin. […] Relieve an area of itchy skin with a cool compress. To make a cool compress, run a clean washcloth under cold water and wring out the washcloth so that water doesnt drip. Then apply your cool compress to the itchy skin and leave it there for 10 to 20 minutes. […] Protect your skin from the sun. If sunlight hits skin with blisters, sores, or rashes, this can be painful. If you need to be outdoors in the sun, protect your skin by seeking shade, wearing sun-protective clothing, and applying sunscreen that offers broad-spectrum protection, water-resistance, and an SPF of 30 or higher. Apply your sunscreen to all skin not covered by clothing.

• #33 Bullous pemphigoid

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20154767

  Bullous pemphigoid often goes away on its own in a few months, but may take as many as five years to resolve. Treatment usually helps heal the blisters and ease any itching. It may include corticosteroid medications, such as prednisone, and other drugs that suppress the immune system. […] Treatment is focused on healing the skin and relieving itching, while minimizing adverse side effects of medications. Your doctor will likely prescribe one or a combination of the drugs: […] If you have bullous pemphigoid, you can help take care of your condition with the following self-care strategies: […] Follow your doctor’s advice for daily care of blisters. […] Limit activities if needed. Blisters on the feet and hands can make it difficult to walk or to go about daily activities. You may need to change your routine until the blisters are under control.

• #34 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Taking good care of yourself at home may help blisters caused by bullous pemphigoid to clear more quickly. Good care can also prevent a serious infection. Heres what dermatologists recommend for their patients who have bullous pemphigoid. […] Bullous pemphigoid makes skin fragile. To help you get the best results from treatment, dermatologists recommend that you: […] Try not to scratch. When you scratch, you can injure your skin. […] Relieve an area of itchy skin with a cool compress. To make a cool compress, run a clean washcloth under cold water and wring out the washcloth so that water doesnt drip. Then apply your cool compress to the itchy skin and leave it there for 10 to 20 minutes. […] Protect your skin from the sun. If sunlight hits skin with blisters, sores, or rashes, this can be painful. If you need to be outdoors in the sun, protect your skin by seeking shade, wearing sun-protective clothing, and applying sunscreen that offers broad-spectrum protection, water-resistance, and an SPF of 30 or higher. Apply your sunscreen to all skin not covered by clothing.

• #35 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Taking good care of yourself at home may help blisters caused by bullous pemphigoid to clear more quickly. Good care can also prevent a serious infection. Heres what dermatologists recommend for their patients who have bullous pemphigoid. […] Bullous pemphigoid makes skin fragile. To help you get the best results from treatment, dermatologists recommend that you: […] Try not to scratch. When you scratch, you can injure your skin. […] Relieve an area of itchy skin with a cool compress. To make a cool compress, run a clean washcloth under cold water and wring out the washcloth so that water doesnt drip. Then apply your cool compress to the itchy skin and leave it there for 10 to 20 minutes. […] Protect your skin from the sun. If sunlight hits skin with blisters, sores, or rashes, this can be painful. If you need to be outdoors in the sun, protect your skin by seeking shade, wearing sun-protective clothing, and applying sunscreen that offers broad-spectrum protection, water-resistance, and an SPF of 30 or higher. Apply your sunscreen to all skin not covered by clothing.

• #36 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Taking good care of yourself at home may help blisters caused by bullous pemphigoid to clear more quickly. Good care can also prevent a serious infection. Heres what dermatologists recommend for their patients who have bullous pemphigoid. […] Bullous pemphigoid makes skin fragile. To help you get the best results from treatment, dermatologists recommend that you: […] Try not to scratch. When you scratch, you can injure your skin. […] Relieve an area of itchy skin with a cool compress. To make a cool compress, run a clean washcloth under cold water and wring out the washcloth so that water doesnt drip. Then apply your cool compress to the itchy skin and leave it there for 10 to 20 minutes. […] Protect your skin from the sun. If sunlight hits skin with blisters, sores, or rashes, this can be painful. If you need to be outdoors in the sun, protect your skin by seeking shade, wearing sun-protective clothing, and applying sunscreen that offers broad-spectrum protection, water-resistance, and an SPF of 30 or higher. Apply your sunscreen to all skin not covered by clothing.

• #37 Bullous pemphigoid

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20154767

  Avoid prolonged sun exposure on any area of the skin affected by bullous pemphigoid. […] Dress in loosefitting cotton clothes. This helps protect your skin. […] Watch what you eat. If you have blisters in your mouth, avoid eating hard and crunchy foods, such as chips and raw fruits and vegetables, because these types of foods might aggravate symptoms.

• #38 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Wear loose-fitting cotton clothing. This will reduce rubbing, which could irritate your skin. […] Limit your activities until the blisters are under control. This means no contact sports, swimming, or heavy household chores. If you have blisters on your feet, limit walking. […] Only pop or drain a blister if your dermatologist tells you to do so. When your dermatologist recommends draining a blister, you will receive instructions on how to do this safely. Without these safety precautions, you could cause a serious, and possibly life-threatening, infection. […] If you have germs on your hands and then touch a blister or skin where a blister just ruptured, you can develop an infection. Washing with soap and water helps to remove germs from your hands. […] Blisters and open skin can easily become infected. Its important to watch for these warning signs of infection on your skin:

• #39 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  For mild cases of bullous pemphigoid, the best treatments are topical corticosteroid creams or ointments that you rub directly on the affected areas. […] For moderate-to-severe cases of bullous pemphigoid, your healthcare provider may prescribe an oral corticosteroid, like prednisone, in addition to a steroid-sparing immunomodulatory agent such as dapsone, mycophenolate mofetil, azathioprine, methotrexate or chlorambucil. […] If you cant take cant corticosteroids or other immunomodulatory agents, your healthcare provider may prescribe oral tetracycline or doxycycline pills. […] For refractory cases of bullous pemphigoid, your healthcare provider may prescribe rituximab or IVIG infusions. […] There arent any home remedies for bullous pemphigoid, but there are things you can do to make your symptoms more tolerable, including: Wear soft, loose-fitting clothing made out of natural fibers.

• #40 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Wear loose-fitting cotton clothing. This will reduce rubbing, which could irritate your skin. […] Limit your activities until the blisters are under control. This means no contact sports, swimming, or heavy household chores. If you have blisters on your feet, limit walking. […] Only pop or drain a blister if your dermatologist tells you to do so. When your dermatologist recommends draining a blister, you will receive instructions on how to do this safely. Without these safety precautions, you could cause a serious, and possibly life-threatening, infection. […] If you have germs on your hands and then touch a blister or skin where a blister just ruptured, you can develop an infection. Washing with soap and water helps to remove germs from your hands. […] Blisters and open skin can easily become infected. Its important to watch for these warning signs of infection on your skin:

• #41 Bullous pemphigoid – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bullous-pemphigoid/diagnosis-treatment/drc-20350419

  Your healthcare professional will talk with you about your symptoms and medical history and conduct a physical exam. You may need tests to confirm a diagnosis of bullous pemphigoid. These may include blood tests, a skin biopsy or both. A biopsy is a procedure to remove a sample of tissue for testing in a lab. […] Treatment of bullous pemphigoid is aimed at healing the skin, relieving itching and pain, and preventing new blisters. Your healthcare professional will likely prescribe one or a combination of medicines: […] Follow your healthcare professional’s advice for care of blisters. […] Blisters on the feet and hands can make it difficult to walk or to go about daily tasks. The itching may make it hard to sleep. You may need to change your routine until the blisters are under control.

• #42 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Wear loose-fitting cotton clothing. This will reduce rubbing, which could irritate your skin. […] Limit your activities until the blisters are under control. This means no contact sports, swimming, or heavy household chores. If you have blisters on your feet, limit walking. […] Only pop or drain a blister if your dermatologist tells you to do so. When your dermatologist recommends draining a blister, you will receive instructions on how to do this safely. Without these safety precautions, you could cause a serious, and possibly life-threatening, infection. […] If you have germs on your hands and then touch a blister or skin where a blister just ruptured, you can develop an infection. Washing with soap and water helps to remove germs from your hands. […] Blisters and open skin can easily become infected. Its important to watch for these warning signs of infection on your skin:

• #43 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Wear loose-fitting cotton clothing. This will reduce rubbing, which could irritate your skin. […] Limit your activities until the blisters are under control. This means no contact sports, swimming, or heavy household chores. If you have blisters on your feet, limit walking. […] Only pop or drain a blister if your dermatologist tells you to do so. When your dermatologist recommends draining a blister, you will receive instructions on how to do this safely. Without these safety precautions, you could cause a serious, and possibly life-threatening, infection. […] If you have germs on your hands and then touch a blister or skin where a blister just ruptured, you can develop an infection. Washing with soap and water helps to remove germs from your hands. […] Blisters and open skin can easily become infected. Its important to watch for these warning signs of infection on your skin:

• #44 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  If you have an infection, you may also feel very hot or cold, or have a fever. […] Take your temperature if you think you might have an infection. If your temperature is higher than 100.4 F (38.0C), call your dermatologist or primary care physician. Tell the person who answers the phone that you have bullous pemphigoid and a fever. […] Treating an infection early can prevent it from spreading and causing a life-threatening illness. […] It can take several weeks for blisters to start drying up and new blisters to stop forming. When you dont see results right away, you may be tempted to stop following your treatment plan. Continue with your treatment plan, making sure that you: […] Care for your blisters and open sores (wound care), as directed. […] Some people who have bullous pemphigoid develop blisters in their mouth. When this happens, dermatologists recommend the following:

• #45 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  If you have an infection, you may also feel very hot or cold, or have a fever. […] Take your temperature if you think you might have an infection. If your temperature is higher than 100.4 F (38.0C), call your dermatologist or primary care physician. Tell the person who answers the phone that you have bullous pemphigoid and a fever. […] Treating an infection early can prevent it from spreading and causing a life-threatening illness. […] It can take several weeks for blisters to start drying up and new blisters to stop forming. When you dont see results right away, you may be tempted to stop following your treatment plan. Continue with your treatment plan, making sure that you: […] Care for your blisters and open sores (wound care), as directed. […] Some people who have bullous pemphigoid develop blisters in their mouth. When this happens, dermatologists recommend the following:

• #46 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  If you have an infection, you may also feel very hot or cold, or have a fever. […] Take your temperature if you think you might have an infection. If your temperature is higher than 100.4 F (38.0C), call your dermatologist or primary care physician. Tell the person who answers the phone that you have bullous pemphigoid and a fever. […] Treating an infection early can prevent it from spreading and causing a life-threatening illness. […] It can take several weeks for blisters to start drying up and new blisters to stop forming. When you dont see results right away, you may be tempted to stop following your treatment plan. Continue with your treatment plan, making sure that you: […] Care for your blisters and open sores (wound care), as directed. […] Some people who have bullous pemphigoid develop blisters in their mouth. When this happens, dermatologists recommend the following:

• #47 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  Wash your sores or ulcers with antibacterial soap and water to prevent infection. Then, apply antibiotic ointment to your affected areas and wrap them in nonadhesive (doesnt stick to your skin) bandages. […] If you have bullous pemphigoid in your mouth, the following tips can make your symptoms more tolerable and help prevent nutrition problems: Eat a diet of soft foods, such as soups, mashed foods, pudding and applesauce. […] Avoid crunchy or sharp foods, including chips, cereal, crusty bread and raw vegetables and fruits. […] Avoid drinking alcohol. […] You should start to feel better a few days after starting treatment.

• #48 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Use a soft toothbrush. This helps reduce irritation and possible pain. […] Rinse with an alcohol-free antiseptic mouthwash. Dermatologists recommend rinsing with this mouthwash, as it helps to prevent infection and can help you feel better. Just make sure the mouthwash is alcohol-free, as alcohol can irritate the blisters. […] You will need to see your dermatologist for follow-up care. During these visits, your dermatologist will: […] Its important that you keep all of these appointments, too. […] Both people who have bullous pemphigoid and their caregivers can find it difficult to cope. If that describes you, help is available.

• #49 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Use a soft toothbrush. This helps reduce irritation and possible pain. […] Rinse with an alcohol-free antiseptic mouthwash. Dermatologists recommend rinsing with this mouthwash, as it helps to prevent infection and can help you feel better. Just make sure the mouthwash is alcohol-free, as alcohol can irritate the blisters. […] You will need to see your dermatologist for follow-up care. During these visits, your dermatologist will: […] Its important that you keep all of these appointments, too. […] Both people who have bullous pemphigoid and their caregivers can find it difficult to cope. If that describes you, help is available.

• #50 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  Wash your sores or ulcers with antibacterial soap and water to prevent infection. Then, apply antibiotic ointment to your affected areas and wrap them in nonadhesive (doesnt stick to your skin) bandages. […] If you have bullous pemphigoid in your mouth, the following tips can make your symptoms more tolerable and help prevent nutrition problems: Eat a diet of soft foods, such as soups, mashed foods, pudding and applesauce. […] Avoid crunchy or sharp foods, including chips, cereal, crusty bread and raw vegetables and fruits. […] Avoid drinking alcohol. […] You should start to feel better a few days after starting treatment.

• #51 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  Wash your sores or ulcers with antibacterial soap and water to prevent infection. Then, apply antibiotic ointment to your affected areas and wrap them in nonadhesive (doesnt stick to your skin) bandages. […] If you have bullous pemphigoid in your mouth, the following tips can make your symptoms more tolerable and help prevent nutrition problems: Eat a diet of soft foods, such as soups, mashed foods, pudding and applesauce. […] Avoid crunchy or sharp foods, including chips, cereal, crusty bread and raw vegetables and fruits. […] Avoid drinking alcohol. […] You should start to feel better a few days after starting treatment.

• #52 Bullous pemphigoid

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20154767

  Avoid prolonged sun exposure on any area of the skin affected by bullous pemphigoid. […] Dress in loosefitting cotton clothes. This helps protect your skin. […] Watch what you eat. If you have blisters in your mouth, avoid eating hard and crunchy foods, such as chips and raw fruits and vegetables, because these types of foods might aggravate symptoms.

• #53 Bullous Pemphigoid: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15855-bullous-pemphigoid

  Wash your sores or ulcers with antibacterial soap and water to prevent infection. Then, apply antibiotic ointment to your affected areas and wrap them in nonadhesive (doesnt stick to your skin) bandages. […] If you have bullous pemphigoid in your mouth, the following tips can make your symptoms more tolerable and help prevent nutrition problems: Eat a diet of soft foods, such as soups, mashed foods, pudding and applesauce. […] Avoid crunchy or sharp foods, including chips, cereal, crusty bread and raw vegetables and fruits. […] Avoid drinking alcohol. […] You should start to feel better a few days after starting treatment.

• #54 Bullous Pemphigoid Treatment & Management: Medical Care, Complications, Diet

  https://emedicine.medscape.com/article/1062391-treatment

  Treatment of patients with bullous pemphigoid requires coordination of care between the dermatologist and the patient’s primary care provider. Patients with oral disease may require an otolaryngologist and/or a dentist for evaluation and care. An ophthalmologist should evaluate patients with suspected ocular involvement and those requiring prolonged high-dose steroids.

• #55 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Use a soft toothbrush. This helps reduce irritation and possible pain. […] Rinse with an alcohol-free antiseptic mouthwash. Dermatologists recommend rinsing with this mouthwash, as it helps to prevent infection and can help you feel better. Just make sure the mouthwash is alcohol-free, as alcohol can irritate the blisters. […] You will need to see your dermatologist for follow-up care. During these visits, your dermatologist will: […] Its important that you keep all of these appointments, too. […] Both people who have bullous pemphigoid and their caregivers can find it difficult to cope. If that describes you, help is available.

• #56 Long-term oral prednisolone exposure in primary care for bullous pemphigoid: population-based study | British Journal of General Practice

  https://bjgp.org/content/71/713/e904

  Conversations between primary and secondary care physicians involved in their care should address steroid-sparing alternatives and, when switching is not possible, ensure prophylactic treatment (for example, bone-sparing treatments) and proactive monitoring of side effects are in place. […] Strict monitoring and proactive management are required to minimise the risks to this population. […] Clinicians are exposing people with bullous pemphigoid to substantial iatrogenic risks as a result of prednisolone prescribing. […] Strict monitoring and careful consideration of prophylactic treatments, such as bone-protection therapies, are essential for their long-term management.

• #57 Bullous pemphigoid: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000883.htm

  Bullous pemphigoid is a skin disorder characterized by blisters. […] Anti-inflammatory medicines called corticosteroids may be prescribed. They may be taken by mouth or applied to the skin. More powerful medicines may be used to help suppress the immune system if steroids do not work, or to allow lower steroid doses to be used. […] Your provider may suggest self-care measures. These may include: […] Applying anti-inflammatory creams to the skin […] Using mild soaps and applying moisturizer to the skin after bathing […] Protecting the affected skin from sun exposure and injury. […] Bullous pemphigoid usually responds well to treatment. The medicine can often be stopped after several years. The disease sometimes returns after treatment is stopped. […] Skin infection is the most common complication. […] Contact your provider if you have: […] Unexplained blisters on your skin […] An itchy rash that continues despite home treatment.

• #58 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  If you have an infection, you may also feel very hot or cold, or have a fever. […] Take your temperature if you think you might have an infection. If your temperature is higher than 100.4 F (38.0C), call your dermatologist or primary care physician. Tell the person who answers the phone that you have bullous pemphigoid and a fever. […] Treating an infection early can prevent it from spreading and causing a life-threatening illness. […] It can take several weeks for blisters to start drying up and new blisters to stop forming. When you dont see results right away, you may be tempted to stop following your treatment plan. Continue with your treatment plan, making sure that you: […] Care for your blisters and open sores (wound care), as directed. […] Some people who have bullous pemphigoid develop blisters in their mouth. When this happens, dermatologists recommend the following:

• #59 Bullous Pemphigoid: Know the Facts

  https://www.webmd.com/skin-problems-and-treatments/what-is-bullous-pemphigoid

  If the blisters are widespread and severe enough, you might need specialized wound care in a hospital burn unit, where the staff has special expertise in wound care. […] It can take several years for bullous pemphigoid to go away completely. In the meantime, your doctor will monitor your progress to see how the treatment is working, and may switch drugs if needed. Some medications can have serious side effects, so report anything unusual to your doctor. You might need regular tests, like a bone density (DEXA) scan, blood pressure monitoring, or blood tests to make sure that you arent having any hidden side effects. […] If your doctor prescribes treatment to manage the blisters and other bullous pemphigoid symptoms, it can take a while before you see or feel any changes. In the meantime, there are some things that you can try at home to help your skin feel at least a bit better:

• #60 Bullous pemphigoid

  https://www.pcds.org.uk/clinical-guidance/bullous-pemphigoid1

  Bullous pemphigoid commonly starts with itching and fixed urticarial-like lesions or occasionally an eczematous rash, which predominantly affects the limbs. […] The vast majority of patients need urgent referral to Secondary Care, and those with widespread blistering may require admission. A few patients, eg those with localised disease, may be suitable for management in Primary Care. […] Supportive measures include wound care and reducing the risk of secondary infection by using antiseptic regimes, eg Dermol 500 lotion as a wash and / or topical emollient. […] Dermovate cream (clobetasol) is a very effective treatment for localised disease. It can also be tried BD in more extensive disease, as the side effects are very much less then when compared to systemic steroids. […] Systemic steroids are the mainstay of treatment. The initial dose is as follows: 20 mg / day in localised-mild disease, 40 mg / day in moderate disease, 50-70 mg / day in severe disease. […] In addition to providing gastric protection with a PPI, treatment to help prevent osteoporosis should be initiated at an early stage.

• #61 Long-term oral prednisolone exposure in primary care for bullous pemphigoid: population-based study | British Journal of General Practice

  https://bjgp.org/content/71/713/e904

  Conversations between primary and secondary care physicians involved in their care should address steroid-sparing alternatives and, when switching is not possible, ensure prophylactic treatment (for example, bone-sparing treatments) and proactive monitoring of side effects are in place. […] Strict monitoring and proactive management are required to minimise the risks to this population. […] Clinicians are exposing people with bullous pemphigoid to substantial iatrogenic risks as a result of prednisolone prescribing. […] Strict monitoring and careful consideration of prophylactic treatments, such as bone-protection therapies, are essential for their long-term management.

• #62 Bullous pemphigoid – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bullous-pemphigoid/diagnosis-treatment/drc-20350419

  Try not to scratch the affected area. And protect your skin from too much heat and sun, even on cool, cloudy or hazy days. […] Bullous pemphigoid may be difficult to live with, especially if it affects your daily activities or causes lost sleep or stress. You may find it helpful to talk with others who have or had bullous pemphigoid. You may want to connect with a support group in person or online. Ask your healthcare professional for suggestions.

• #63 Bullous pemphigoid – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bullous-pemphigoid/diagnosis-treatment/drc-20350419

  Try not to scratch the affected area. And protect your skin from too much heat and sun, even on cool, cloudy or hazy days. […] Bullous pemphigoid may be difficult to live with, especially if it affects your daily activities or causes lost sleep or stress. You may find it helpful to talk with others who have or had bullous pemphigoid. You may want to connect with a support group in person or online. Ask your healthcare professional for suggestions.

• #64 Bullous Pemphigoid – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK535374/

  Immunosuppressive therapy is used when steroids do not control the disease or if patients have contraindications for systemic corticosteroid treatments. […] This disease can render the patient’s skin fragile and susceptible to microbial invasion. Patients need to avoid trauma to their skin. Skin hygiene is a crucial component of preventing complications, and patients need to recognize both complications and adverse events from treatment so they can report these to their clinicians. […] Most general practitioners and primary care providers may not be familiar with bullous pemphigoid. This is a serious skin disorder with a very high morbidity and mortality rate. When patients present with large bullae, it is important to seek a dermatology consultation. The sooner the disorder is treated, the better the prognosis.

• #65 Bullous pemphigoid: Self-care

  https://www.aad.org/public/diseases/a-z/bullous-pemphigoid-self-care

  Use a soft toothbrush. This helps reduce irritation and possible pain. […] Rinse with an alcohol-free antiseptic mouthwash. Dermatologists recommend rinsing with this mouthwash, as it helps to prevent infection and can help you feel better. Just make sure the mouthwash is alcohol-free, as alcohol can irritate the blisters. […] You will need to see your dermatologist for follow-up care. During these visits, your dermatologist will: […] Its important that you keep all of these appointments, too. […] Both people who have bullous pemphigoid and their caregivers can find it difficult to cope. If that describes you, help is available.

• #66 Bullous pemphigoid – General Nursing Support

  https://allnurses.com/bullous-pemphigoid-t64234/?do=findComment&comment=595684

  Have any of you guys taken care of anyone with a disorder named bullous pemphigoid? It is horrible! CNAs are asking if what this person has is contageous and if it is going to kill this resident. This resident has huge blisters, some filled with blood and some with viscous fluid. They grow large then burst, leaving flattened scars that are becoming infected. She stays up all night just scratchng and scratching. We have mitts on her, but she scratches with the mitts. […] I don’t have any suggestions to offer. I have seen one patient with this and it is indeed horrid to witness. Same scenerio as yours, we had to put mittens on and wrap her arms with rolls of gauze to keep her from scratching. We treated her as you said, with steriods. […] Yes, I have seen a few patients with it. As far as I remember, it is not contagious. It looks terrible though! I think it is auto immune disorder.

• #67 Bullous pemphigoid – General Nursing Support

  https://allnurses.com/bullous-pemphigoid-t64234/?do=findComment&comment=595684

  Treatment is directed at reducing the inflammatory response and autoantibody production. Although target-specific therapy is the holy grail for immunodermatologists, non-target-specific treatments are currently used. The most commonly used medications are anti-inflammatory agents (eg, corticosteroids, tetracyclines, dapsone) and immunosuppressants (eg, azathioprine, methotrexate, mycophenolate mofetil, cyclophosphamide). […] When I was a wound care nurse I had 2 patients with this disorder. It is not contagious. I know it will frighten the staff, but tell them not to worry. Check her mouth periodically, because the lesions can appear there and prevent the patient from eating. It is an autoimmune disorder and the treatment of choice is steroids, both topical and systemic. […] Bullous pemphigoid can be chronic and mild without affecting the general health of affected individuals. Treatment of bullous pemphigoid can resolve with topical cortisone creams, but sometimes requires high doses of cortisone („steroids”) taken internally. Severe bullous pemphigoid can also require immune suppression drugs, such as azathoprine (Imuran).

• #68

  https://www.ttsh.com.sg/Patients-and-Visitors/Pages/Find-Conditions-and-Treatments-Details.aspx?condition=Bullous-Pemphigoid

  Bullous Pemphigoid (BP) is a skin disorder that causes blisters. It usually occurs in elderly people aged over 60. This condition is not contagious. […] The blisters occur when your body produces antibodies that attack the tissue just below your outermost layer of skin. This causes the layers of your skin to separate and results in itchy and sometimes painful blisters. […] It cannot be cured, but treatments are usually successful to relieve the symptoms. In many cases, the symptoms may become under control with little or no medications. However, do note that the symptoms may re-occur. Your doctor may prescribe oral medications such as corticosteroids / immunosuppressants / antibiotics / painkillers. […] Wash your skin with prescribed solution or soap. Apply thin layer of prescribed creams or ointments such as corticosteroids or antibiotics. Apply moisturisers to dry skin regularly. DO NOT break the blisters unless instructed by your doctor. If the blister breaks, cover it with sterile non-adherent dressing. Avoid eating foods that may trigger or worsen ulcers in the mouth. It is recommended to have a high protein diet to replace loss of protein. Attend your follow-up appointment. This is to ensure that your treatment and prescribed drugs are effective.

• #69 Bullous Pemphigoid Nursing Care Plan – Planning for Care

  https://planningforcare.co.uk/product/bullous-pemphigoid/

  Bullous Pemphigoid Nursing Care Plan […] Bullous Pemphigoid is an autoimmune disease, which causes the skin to blister. The blisters can be large, measuring up to 3cm across, and may be itchy and painful, they appear mainly on the trunk, arms, and legs. Occasionally, the inner lining tissue of the mouth, mucous membrane tissue, can be involved. […] This condition is not infectious. The majority of cases of Bullous Pemphigoid occur in people 50 years of age or older. The condition can resolve with topical cortisone creams but sometimes requires high doses of steroids taken internally. Severe Bullous Pemphigoid can also require immune-suppression drugs. […] This care plan sets out a clear explanation of the resident’s issue, and will quickly guide the nurse or carer through the process of preparing a comprehensive, individual person centred Care Plan. […] Nursing Care Plan Features: […] Identifies the symptoms experienced […] Identifies the effects the condition has on the resident […] Details a comprehensive plan of care

• #70

  https://www.ttsh.com.sg/Patients-and-Visitors/Pages/Find-Conditions-and-Treatments-Details.aspx?condition=Bullous-Pemphigoid

  Bullous Pemphigoid (BP) is a skin disorder that causes blisters. It usually occurs in elderly people aged over 60. This condition is not contagious. […] The blisters occur when your body produces antibodies that attack the tissue just below your outermost layer of skin. This causes the layers of your skin to separate and results in itchy and sometimes painful blisters. […] It cannot be cured, but treatments are usually successful to relieve the symptoms. In many cases, the symptoms may become under control with little or no medications. However, do note that the symptoms may re-occur. Your doctor may prescribe oral medications such as corticosteroids / immunosuppressants / antibiotics / painkillers. […] Wash your skin with prescribed solution or soap. Apply thin layer of prescribed creams or ointments such as corticosteroids or antibiotics. Apply moisturisers to dry skin regularly. DO NOT break the blisters unless instructed by your doctor. If the blister breaks, cover it with sterile non-adherent dressing. Avoid eating foods that may trigger or worsen ulcers in the mouth. It is recommended to have a high protein diet to replace loss of protein. Attend your follow-up appointment. This is to ensure that your treatment and prescribed drugs are effective.

• #71 Bullous Pemphigoid: Understanding and Managing this Rare Skin Disorder | Maggie Yu MD, IFMCP

  https://drmaggieyu.com/blog/bullous-pemphigoid-a-detailed-guide-to-understanding-and-managing-this-rare-skin-disorder/

  Bullous pemphigoid, a disease examined by dermatologists, is a skin disorder that primarily presents with blisters and hives. This condition involves the immune system producing autoantibodies. These bullous lesions, also known as skin disorders, are tense blisters filled with fluid, often requiring a dermatologist’s expertise in disease and wound care. […] Doctors usually prescribe topical clobetasol, a potent corticosteroid cream. You apply it directly to the blisters and rashes. […] Regularly cleaning the affected areas with mild soap and warm water helps prevent infection. Applying moisturizers keeps your skin hydrated and reduces itching—a common symptom of this disorder. […] Emotional support and stress management play a vital role in managing bullous pemphigoid. Living with a rare skin disorder is tough—it can feel isolating at times. That’s why having a strong support system is so important. Family members, friends, or support groups—these people can provide comfort during challenging times.

• #72 Bullous pemphigoid

  https://www.nhs.uk/conditions/bullous-pemphigoid/

  Bullous pemphigoid eventually goes away on its own. […] Treatment can help your skin heal, stop new patches or blisters appearing, and lower the chances of your skin getting infected. […] Do not burst your blisters yourself unless you have been shown how to by a nurse. Your skin might get infected. […] It’s important to go to check-ups with your doctor so problems can be found and treated early.

Zobacz więcej