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Bullous Pemphigoid

Treatment of Bullous Pemphigoid

Bullous Pemphigoid is an autoimmune disorder, which means the immune system is malfunctioning. Instead of defending the body, it attacks healthy body cells even when there is no infection. This causes inflammation. Bullous Pemphigoid is the term used for chronic blistering of the skin that normally appears in people older than fifty years. It can range from mildly itchy and small welts to very large and painful blisters with severe infection. It can be widespread or only located at a small area. Bullous is the medical term for the large blisters filled with clear fluids. They appear at flexural areas of the body but can also be found in the mouth and esophagus. It is a self-containing disease that normally completely clears up after sufficient treatment but can reappear after years. Men and woman are both at risk. Children may also develop these blisters. It is not contagious but may be hereditary.

Symptoms

The skin lesions called bullae start as red wheals and evolve to large blisters over a period of months. The bullae are red and oval or round shaped. They may rupture and cause painful erosions of the skin. You may experience itching and pain. They sometimes appear in the mouth, vagina area and anus as well but are mostly found at the lower legs, stomach, inner thighs and armpits. Some of the lesions become infected and painful when you scratch them.

Causes

  1. People who suffer from other immune disorders such as diabetes may sometimes suffer from Bullous Pemphigoid as well.
  2. A number of drugs such as penicillin and furosemide can trigger the appearance of the blisters.
  3. Burns from radiation and the sun may also trigger the appearance of the blisters.

Diagnosis

Since there are so many different symptoms and degrees of Bullous Pemphigoid, a skin biopsy is needed for the correct diagnosis. A skin biopsy can be done at outpatient facilities. The method depends on the severity and location of the blister. A local anesthetic is used. The shave biopsy entails the removal of the top layers of skin. A punch biopsy is performed when the skin lesions are deeper where a small part of the skin is removed with a hollow instrument and the wound is closed with stitches. Blood tests are not conclusive.

Treatment

There is no cure for Bullous Pemphigoid. Treatment focuses on the prevention of infection and relief of the symptoms. Certain antibiotics such as Tetracycline and Mincolycine can be used to treat mild symptoms. These antibiotics have side effects and cannot be used for long periods without damage to a person’s health.

Oral steroids are sometimes prescribed for severe Bullous Pemphigoid cases. The dermatologist monitors the patient closely and adjusts the prescription accordingly. The steroids have severe side effects. The treatment may continue for months and even years. Other immunosuppressive agents are used with oral steroids to lower the dosage. Severe cases are normally treated in hospital to allow intravenous injections.

Immunosuppressive agents suppress the immune system to ensure that it doesn’t act against healthy cells.

Take cleansing baths, dress the wounds and keep them cleaned.

It is important to keep good skin hygiene to prevent outbreaks and secondary infections. Don’t scratch and wear clothes that may cause itching or rub against the bullae.

What can you do to prevent large outbreaks?

  1. Avoid activities that can lead to excessive sweating. If you do sport take a shower or bath after the activity and air-dry your body.
  2. Wash your clothes and linen with a hypoallergenic detergent.
  3. Check for secondary infections and treat it immediately.

Diet

  1. Follow a liquid or soft diet when you have bullae in your mouth and throat to prevent eruptions.
  2. Follow a well-balanced and nutritious diet. Vitamins and minerals are all important but especially magnesium, selenium, manganese, and vitamins A, C, E and B complex. Vitamins C and E are antioxidants that help the body to fight the secondary infections.
  3. Eat enough fiber.

There are a number of herbs and phytonutrients that can help reduce outbreaks and inflammation, such as Siberian ginseng, St. John’s wort, turmeric, 5HTP, ginger, garlic, devil’s claw, peppermint oil, boswellia, bromelain, acetyl-glycocemine, gamma oryzanol, grape seed extract and licorice. Garlic kills bacteria. People with Bullous Pemphigoid can live normal lives with proper care, treatment and diet.


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