Bullous pemphigoid

Bullous pemphigoid (BUL-us PEM-fih-goid) is a rare skin condition that causes large, fluid-filled blisters on areas of skin that often flex — such as the lower abdomen, upper thighs or armpits. Bullous pemphigoid is most common in people older than age 60.

Bullous pemphigoid occurs when your immune system attacks a thin layer of tissue below your outer layer of skin. The reason for this abnormal immune response is unknown, although it sometimes can be triggered by taking certain medications.

Treatment usually includes corticosteroids, such as prednisone, and other drugs that suppress the immune system. Bullous pemphigoid can be life-threatening, especially for older people who are already in poor health.

Symptoms Causes Risk factors Complications

The primary feature of bullous pemphigoid is the appearance of large blisters that don't easily rupture when touched. The fluid inside the blisters is usually clear but may contain some blood. The skin around the blisters may appear normal or red.

In most cases, the blisters appear on the lower abdomen, groin, upper thighs and arms. Blisters are often located along creases or folds in the skin, such as the skin on the inner side of a joint. The affected areas of skin can be very itchy. You might also develop blisters or sores in your mouth. Rarely, the mucous membranes of the eyes can be involved, creating redness, soreness and discomfort.

When to see a doctor

If you develop unexplained blistering — a condition not caused, for example, by a known skin allergy or contact with poison ivy — see your doctor.

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