Bullous pemphigoid: symptoms, treatment and photos

Bullous pemphigoid is a relatively common skin disease, which, by external manifestations, resembles pemphigus. The disease is chronic and in the absence of timely diagnosis and treatment can lead to unpleasant consequences. So what causes the development of such a disease? What symptoms does it manifest? What remedies can modern medicine offer? Many of the readers are interested in answers to these questions.

What is the disease?

Bullous pemphigoid in modern medicine is known by many names - it's Lever's disease, and senile pemphigus, and senile herpetiform dermatitis. This is a chronic autoimmune disease, which is accompanied by the appearance on the skin of a large bubble rash (external symptoms sometimes resemble true pemphigus).

It is worth noting that the majority of patients with this diagnosis are people aged 65 years and over. Of course, medicine also knows exceptions, since the disease is sometimes found in children and middle-aged patients. The disease is characterized by a benign course, but sometimes it can lead to complications. In the clinical picture, periods of relative well-being alternate with exacerbations. Of course, for many people, the interesting question is what the pemphigoid bullous is. Symptoms and treatment of the disease, the reasons for its appearance - in this information should be read more carefully.

Some similar diseases

It should be noted that bullous pemphigoid is a part of the so-called bladder dermatosis. These ailments differ from the true pemphigus, since they are not accompanied by acantholysis. The group of skin lesions includes a few more ailments, the clinical picture of which is quite similar:

• Benign neakantoliticheskaya pemphigus, in which the disease affects only the mucous membrane of the mouth, without causing rashes in other areas. The disease is also characterized by a benign course. By the way, it was first described in 1959.
• Cicatricial pemphigoid is a rather dangerous disease that affects the mucous membrane of the eyes and conjunctiva, causing its atrophy. Eruptions on the body are possible, but are relatively rare. The main risk group is women of 50 years of age, although sometimes the disease is registered among male patients.

Causes and pathogenesis of bullous pemphigoid

Unfortunately, the mechanism of the onset of this disease is not yet fully understood. Nevertheless, scientists managed to find out that the disease has an autoimmune character. For various reasons, the immune system malfunctions, resulting in the produced antibodies attacking not only the alien, but also the body's own cells.

There are proofs of this theory. During the studies in the patient's blood serum, as well as in the liquid taken from the blisters, specific antibodies were found that damage the basal membrane of the tissues of the skin and mucous membranes. It was also possible to establish that the more active the disease develops, the higher the titer of these antibodies.

It is believed that autoimmune diseases are genetically determined. Nevertheless, a factor is required that can activate the disease. It can be:

• Vaccination against certain diseases;
• Damage or severe skin irritation;
• Exposure to ultraviolet radiation (long sunbathing, abuse of the solarium, etc.);
• Thermal skin burns;
• Frequent intake of certain medications, for example, Furosemide, Captopril, Fenacetin, Amoxicillin and some others;
• Sometimes the disease is activated after the patient has undergone a course of radiation therapy;
• Rejection of the kidney transplant, repeated organ transplantation.

Bullous pemphigoid: photos and symptoms

Of course, first of all it's important to get acquainted with the symptoms, because the earlier the patient pays attention to the presence of violations and will consult a doctor, the easier the treatment process will go. Education on the skin of intense blistering rashes is the main symptom that accompanies the bullous pemphigoid (photo shows how the rash looks). Most often the skin of extremities and trunk is affected. Rashes can occur in the area of large natural folds, on the skin of the face and head, but this happens less often.

The main elements of the rashes are vesicles and blisters with strained tires. Inside, they contain a liquid, usually clear, but sometimes you can notice the impurity of blood. Often the skin around the blisters turns red.

The term "life" of the formations is several days. After that, they open themselves spontaneously. On the site of eruptions, erosion sites and small sores are formed. Cracks on the surface are practically not formed, as erosion areas quickly epithelize.

The first stages of the development of the disease in 20% of patients begin with the appearance of vesicles on the oral mucosa, and only then the rash passes to the skin. Blisters on the mucous membrane of the nose, pharynx, genital organs, eyes appear extremely rarely.

Patients complain of itching, and after opening the blisters and some kind of soreness. There may be an increase in temperature, although this is rarely observed. In elderly patients, whose body is exhausted by frequent relapses, there is also a decrease in appetite, weight loss, progressive weakness.

Histogenesis, histopathology and pathomorphology

The pathomorphology of the bullous pemphigoid is quite interesting. First, numerous vacuoles are formed between the cytoplasmic processes of the basal cells. Gradually, these formations merge, forming larger structures. Along with this, there is a sharp edema of the dermis tissue.

Bubble cover is epidermal tissue. Her cells are stretched, but the bridges between them are intact. As the disease develops, the epidermis cells gradually die off. At the same time, new epidermal tissues are coming from the edges of the bladder, seizing its bottom - thus, the vesicle moves inside the epidermis, and sometimes into the subthreshold layer.

Inside the bladder there is a fluid that contains lymphocytes with an admixture of neutrophils. There are filaments of fibrin, protein molecules and some other compounds.

If we consider the histogenesis of bullous pemphigoid, then first it is worth remembering that the disease is autoimmune. When examining tissues with an electron microscope, you can see that the so-called BPAg1 antigens that are released during an immune reaction are located in the basal layer, namely at the sites of hemodesmosomes of keratinocytes. Another antigen, BPAg2, is also located in the hemidejmosome region. It is believed that it is formed by type XII collagen.

Also during the research it was found that macrophages and eosinophils in this disease first accumulate in the basal membrane, after which they migrate through it and begin to accumulate inside the bladder and between the basal cells. There is also a significant degranulation of mast cells.

Histologically, the disease detaches the epidermis from the dermis, between which a subepidermal bladder is formed. Vessels in skin tissues are also dilated, edema of their inner layers (endothelium) is observed.

Modern diagnostic methods

As a rule, there are no difficulties with the diagnosis of a disease such as bullous pemphigoid: the symptoms here are very characteristic, and therefore the doctor may suspect the ailment already during a routine examination. On the patient's skin, intense bubbles form, and the process of epithelialization of erosions proceeds rapidly.

The test for exfoliation of the epidermis is negative. In addition, the internal contents of the blisters are taken with further histological examination. During laboratory tests, vacuoles, histiocytic elements, eosinophils and lymphocytes can be detected in the liquid.

On the other hand, differential diagnosis is sometimes difficult, because the clinical picture is slightly similar to other skin diseases, including multiform exudative erythema, true pemphigus and herpetiform dermatitis of Dühring.

What treatment is considered effective?

What if you have a bullous pemphigoid? Treatment in this case requires a comprehensive. Moreover, the selection of recreational activities and medications depends on many factors, including the severity of the disease, the age and general health of the patient, the presence of concomitant pathologies. In any case, the treatment regimen can be made only by the attending physician.

The basis of therapy - steroidal anti-inflammatory drugs containing glucocorticosteroids. Most often, Prednisolone is used for this purpose. The drug is administered intravenously, and the dose gradually decreases as the symptoms disappear.

Cytostatics and immunosuppressors also help to normalize the immune system. Quite often, patients are prescribed such drugs as "Cyclosporin A", "Cyclophosphamide", "Azathioprine."

Naturally, the important point is also the treatment of rashes, erosions and sores on the skin. It is necessary to keep the skin clean. Patients are assigned solutions with aniline dyes (for example, "Furkocin"), which act as antiseptics, drying out the skin. In more severe cases, ointments with steroids are also required.

Treatment with folk remedies

Bullous pemphigoid, or Lever's disease, is a pathology that requires competent, qualified treatment. The use of various home-made medicines is possible, but only with the permission of a specialist. Before using any medication, always consult your doctor. In folk medicine, many different medicines are used.

• It is believed that the tincture of Eleutherococcus will be positive on the patient's state of health. Take it twice a day, 30 drops each.
• For the external treatment of rashes, juice is used from the leaves of aloe, which helps to remove itching and soreness, prevents the development of the inflammatory process, accelerates the regeneration processes. You need to moisten the bandage with juice, then apply it to the damaged area of the skin and fasten it with a bandage. To achieve maximum effect, you can cover the compress with a polyethylene film.
• For the same purpose, fresh juice or a decoction of nettle leaves can be used. Compress is done according to the scheme described above.
• Bullous pemphigoid, more precisely, its symptoms can be mitigated with the help of a special herbal decoction. For its preparation take an equal amount (50 grams) of eucalyptus leaves, the roots of the coil, Japanese Sophora fruits, birch buds, yarrow herb, shepherd's bag and nettle. Two spoons of the prepared mixture of herbs in the evening, pour a glass of boiling water and leave overnight. In the morning the infusion should be filtered and divided into three portions - they are taken during the day.

It is worthwhile to understand that herbal medicines for each patient can act in different ways. Even if the drug has a positive effect, in no case should not abandon the drug therapy.

Forecast for patients

Pemphigoid is a benign skin disease, and therefore it is not too heavy in most cases. Moreover, practically in any hospital in a large city, a successful treatment of a disease under such a complicated name is carried out - the bullous pemphigoid. In Orenburg, Moscow and any other city you are sure to find a good specialist. From the place of residence will depend only on the cost of therapy, as the prices of these or other drugs in different pharmacy points vary.

With proper treatment, it is possible to achieve a stable remission. From time to time, some patients have relapses, which, of course, is unpleasant, but not fatal. On the other hand, in the absence of therapy, the place of formation of rashes can become a gateway to infection, which, accordingly, ends with a more massive inflammatory process, suppuration of wounds, penetration of pathogenic bacteria into the deeper layers of the skin.

Are there any means of prevention?

Unfortunately, there is no specific remedy for the prevention of such a disease, as the bullous pemphigoid Levera. Naturally, it is extremely important to ask for help in time, and since the disease is chronic, even during periods of relative well-being, one must carefully monitor the state of health.

Do not forget that the disease in medicine is regarded as a possible marker of oncology. Therefore, in the presence of ailment, the patient must undergo a comprehensive examination in order to confirm or exclude an oncological diagnosis. Remember that with any disease it is much easier to cope with if you start therapy at an early stage.