Bullous pemphigus: symptoms in adults and children, causes, treatment, drugs, reviews

August 16, 2017 23:00 | Bullous

Representing the defeat of the upper layer of the epidermis, the pemphigoid bullous is accompanied by the formation on the surface of the skin of numerous bubbles with a strained surface.The most common lesion is seen in older people.This autoimmune disease, which is chronic, is accompanied by an increase in the sensitivity of affected areas of the skin, their reddening, the blisters may have a watery or hemorrhagic filling.

There are cases when the pemphigoid bullous appeared at a younger age;But most often this pathology of the skin is typical for the elderly.Most often, blisters with this disease occur on the skin of the hands, abdomen, neck.Their location is often symmetrical, the bubbles have a pronounced strained surface.

Features of pathology

Pemphigoid bullous is accompanied by a general deterioration of the human condition: frequent weakness, headaches and muscle pains, the skin acquires increased sensitivity.Tissues affected by the disease have a marked color change, many of the symptoms o

f the disease coincide with the manifestation of such skin lesions as pemphigus.

Diagnosis of bullous pemphigoid is performed by examining the affected skin areas, as well as analyzing the obtained data on the blood state.The quality of the patient's immune system is also investigated, since this lesion is most often observed with a decrease in the efficiency of the functioning of the human immune system.


This skin pathology is well curable at a younger age;However, when the age reaches 65 years and above, the degree of effectiveness of the treatment is reduced.And, depending on the age category of the patient, the disease can be classified as follows:

  • is the old bullous pemphigoid , noted in old age.As the data of medical statistics show, after reaching 65 years the probability increases year by year by 150%;
  • is an infantile version of the lesion, which is noted at a younger school age;
  • Adolescent bullous pemphigoid - this variety is diagnosed at puberty at the age of 13-16.

Manifestations for any form of this pathology are identical and require the same therapeutic effect.

Development stages

This pathological process also differs in its development stage.

  1. The first stage of is characterized by the appearance of a significant amount of itchy skin, usually the hands, the lower abdomen, the neck.
  2. The second stage of is manifested in the formation of small size bubbles partially buried in the upper part of the epidermis.Such papules are highly traumatic, and inside they are usually filled with a serous and sometimes purulent fluid.
  3. The development of the papules, which take the form of convex bubbles with a strained surface, is further noted.The skin around them becomes more sensitive, its pigmentation can change.

When the bubbles are opened, a moist and sensitive surface remains, which is quickly restored, with almost no scars left on the skin.

Causes of

Pemphigoid bullous can occur due to certain reasons, or when combined. To date, the causes of this skin lesion have not been clarified to the end, but the most probable is a mutation of genes, which is inherited and can manifest as any skin lesions. The autoimmune nature of the disease manifests itself in the possibility of manifesting certain differences in different patients.

The symptomatology of the disease is sufficiently characteristic that it can be detected even at early stages of development.Current processes in the upper layer of the epidermis are characterized by infiltration of the skin with external manifestations, which are manifested by different localization sites and the possibility of affecting significant areas of skin area.

Symptoms of bullous pemphigoid

  • External manifestations of this skin disease are characterized by the formation of blisters on the skin, while in the process of their formation the skin is strongly itchy, its burning and itching is noted.As the bubble grows, the quality of the skin around it changes: it becomes more sensitive, pigmentation can change.
  • When the bubble is opened, a wet surface of pink color with high humidity is formed, which is quickly restored, and almost never remains in the place of the removed bladder.
  • With the activation of the pathological process, general deterioration of the condition is noted, the body temperature may increase, itchy and burning of the skin is disturbed.To remove the itching, antihistamines are often used.


  • The detection of this disease can be limited to external examination of the skin and mucous membranes.
  • However, for a more accurate diagnosis, a microbiological examination of the skin sample should be carried out, and urine and blood test data should be obtained from which the current inflammatory process in the body can be judged.
  • For the analysis of the skin condition, a method of histological examination is also used that allows more accurate determination of the current lesion and does not confuse it with eczema of various nature and dermatitis.


The treatment is based on the use of glucocorticosteroids, which largely eliminate the main symptoms of the disease, while eliminating such unpleasant manifestations of pathology as itching and burning of the skin.However, since this disease most often affects the elderly, taking such drugs for them should be severely limited due to a significant number of adverse events.

Methods of stimulating the work of immunity are also used, which makes it possible to accelerate the recovery process, avoid side effects and prevent the possibility of parallel development of other physiological lesions.

Therapeutic methods

  • Therapeutic methods of treatment for the treatment of pemphigus bullous should include sparing regimen, as well as the correction of nutrition, which must be varied, contain the necessary elements for the full functioning of the body.
  • Additional reception of multivitamin preparations allows to stimulate the work of immunity, which has a positive effect on the treatment process.


  • As mentioned above, the most effective is the use of glucocorticosteroids, which remove the main symptoms and provide a rapid recovery of the general condition of the patient.However, treatment with such drugs should be done under the supervision of a doctor to avoid possible negative manifestations.
  • Also in complex treatment, cytotoxic drugs are used that stabilize the work of the excretory system, excluding the possibility of contamination of the patient's body with the products of the disintegration of medications.
  • Antibacterial preparations in the form of ointments, tablets help to eliminate signs of concurrent infection, avoid possible complications.


Surgical intervention for the treatment of bullous pemphigoid is usually not used.

Prevention of the disease

  • As a preventive measure, avoidance of frequent mechanical effects on the skin, especially when it is sensitive, can be recommended.
  • It is also necessary to limit the effect on it of various effects of a different nature - temperature drops of the environment, UV radiation.
  • To prevent recurrence of the disease, you should carefully consider its condition, in case of detection of the initial stage of the disease and the formation on the skin of blisters with a stressed surface, contact a dermatologist for diagnostic purposes.


Survival in pemphigoid bullosa is quite high. The forecast is difficult to set, because this condition is not fully understood and can return to the patient in the form of relapses.The incidence of relapse is about 30-35%.