Pemphigoid is a rare
autoimmune disorder that can develop at any age, including in kids, but that
most often affects the elderly. Pemphigoid is caused by a malfunction of the
immune system and results in skin rashes and blistering on the legs, arms, and
Pemphigoid can also cause
blistering on the mucous membranes. Mucous membranes produce mucous that helps
protect the inside of your body. Pemphigoid can be found on the mucous
membranes in your eyes, nose, mouth, and genitals.
It can also occur during
pregnancy in some women. There is no cure for pemphigoid, but there are various
Types of Pemphigoid
All types of pemphigoid
are caused by your immune system attacking healthy tissue. They appear as
rashes and fluid-filled blisters. The types of pemphigoid differ in terms of
where on the body the blistering occurs and when it occurs.
In cases of bullous
pemphigoid (the most common of the three types), the skin blistering happens
most commonly on the arms and legs where movement occurs. This includes the
areas around the joints and on the lower abdomen.
refers to blisters that form on the mucous membranes. This includes the mouth,
eyes, nose, throat, and genitals. The rash and blistering may begin in one of
these areas and spread to the others if left untreated.
When blistering occurs
during or shortly after pregnancy, it is called pemphigoid gestationis. It is also
called herpes gestationis, although it is not related to the herpes virus. The
blistering typically develops during the second or third trimester, but may
occur at any time during pregnancy or up to six weeks after delivery. Blisters
tend to form on the arms, legs, and abdomen.
Causes and Risk Factors
Pemphigoid is an
autoimmune disease. This means that your immune system mistakenly begins to
attack your healthy tissues. In the case of pemphigoid, your immune system
creates antibodies to attack the tissue just below your outer layer of skin.
This causes the layers of skin to separate and results in painful blistering. It
is not fully understood why the immune system reacts this way in patients with
In many cases, there is no
specific trigger for pemphigoid. In some instances, however, it may be caused
by certain medications, radiation therapy, or ultraviolet light therapy. People
with other autoimmune disorders are found to be at a higher risk for developing
pemphigoid. It is more common in the elderly than in any other age group.
Symptoms of Pemphigoid
The most common symptom of
pemphigoid is blistering that occurs on the arms, legs, abdomen, and mucous
membranes. Hives and itching are also common. The blisters have certain
characteristics, regardless of where on the body they form:
- a red rash
develops before the blisters
- the blisters are
large and filled with fluid that is usually clear, but may contain some blood
- the blisters
are thick and do not rupture easily
- the skin
around the blisters may appear normal or slightly red or dark
blisters are usually sensitive and painful
Your dermatologist will be
able to make a fairly firm diagnosis simply by examining your blisters. Further
testing will be needed to prescribe the right treatment.
Your doctor may want to
perform a biopsy, which involves removing small samples of skin from the
affected areas (skin biopsy). Lab technicians will test these samples for the
immune system antibodies characteristic of pemphigoid. These antibodies can
also be detected in your blood, so you may need to have a small sample of blood
Treatments for Pemphigoid
Pemphigoid cannot be
cured, but treatments are usually very successful at relieving symptoms.
Corticosteroids, either in pill or topical form, will likely be the first
treatment your doctor prescribes. These medications reduce inflammation and can
help to heal the blisters and relieve itching. However, they can also cause
serious side effects, especially from long-term use, so your doctor will take
you off of the corticosteroids after the blistering clears up.
Another treatment option
is to take medication that suppresses your immune system, often in conjunction
with the corticosteroids. Immunosuppressants help, but they put you at risk for
other infections. Certain antibiotics, such as tetracycline, may also be
prescribed to reduce inflammation and infection.
treatment, the outlook for pemphigoid is good. Most people respond well to
medication. The disease will often go away after a few years of treatment. Pemphigoid
may return at any time, even with proper treatment.