Ver el código de «Bullous pemphigoid»

==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<ref>http://emedicine.medscape.com/article/1062391-overview</ref>
*May be intensely pruritic
*Nikolsky sign negative
*Involves mucosa in 10-25%, may limit PO intake

==Differential Diagnosis==
{{Bullous rashes DDX}}

==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). 
*Most will require therapy for 6-60 months, mortality asso w disease usually secondary to medications

''Topical corticosteroids may offer similar treatment effect as oral steroids with less systemic effects.''<ref>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].</ref><ref>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]. </ref><ref> 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].</ref>
*Derm referral for dx via biopsy

==Sources==
<references/>

==See Also==
*[[Fever and Rash]]
*[[Visual diagnosis (main)]]

[[Category:Derm]]