Diagnosed with bullous pemphigoid 1 year ago
“The blisters are unsightly and all over my body, with intense itch. It’s hard to deal with.”
SIGNS AND SYMPTOMS
- Initially noticed erythema that persisted for several months before tense bullae appeared
- Bullae on the trunk subsequently manifested on arms, legs, and the armpits
- Now cites increased discomfort from bullae and erosions across the body
- Rates itch intensity as 7 out of 10
HEALTH CONSIDERATIONS
- Taking medication for type 2 diabetes, hypertension, and hypercholesterolemia
TREATMENT AND GOALS
- Was initially prescribed topical corticosteroids (TCS) while awaiting laboratory results to confirm diagnosis
- Upon diagnosis, an oral corticosteroid (OCS) was prescribed
- OCS was quickly tapered due to diabetic background and replaced with a conventional immunosuppressant
- Has experienced some improvement with a conventional immunosuppressant, but disruptive itch and bullae remain, requiring OCS reinitiation
- Wants improvement in bullous pemphigoid signs and symptoms, with potentially less OCS use
Real image of bullous pemphigoid.
Story inspired by people who suffer from bullous pemphigoid.
Recently diagnosed with bullous pemphigoid; symptomatic for 2 years
“The itch is constant, on top of everything else.”
SIGNS AND SYMPTOMS
- Noticed unexplained itch before erythematous and urticarial lesions began to appear
- Later developed bullae on the trunk
- Itch has become more intense—an 8 out of 10—and incessant
HEALTH CONSIDERATIONS
- Taking medication for gastroesophageal reflux disease (GERD), asthma, and seasonal allergies
TREATMENT AND GOALS
- Was prescribed topical corticosteroids (TCS) by primary care, but remained symptomatic and undiagnosed before referral to dermatology
- Dermatologist prescribed oral corticosteroids (OCS), which provided some control when taken at high doses
- Signs and symptoms worsen after tapering off OCS
- Primary goal is to help reduce itch
Real image of bullous pemphigoid.
Story inspired by people who suffer from bullous pemphigoid.
Diagnosed with bullous pemphigoid 1 year ago
“The blisters are unsightly and all over my body, with intense itch. It’s hard to deal with.”
SIGNS AND SYMPTOMS
- Initially noticed erythema that persisted for several months before tense bullae appeared
- Bullae on the trunk subsequently manifested on arms, legs, and the armpits
- Now cites increased discomfort from bullae and erosions across the body
- Rates itch intensity as 7 out of 10
HEALTH CONSIDERATIONS
- Taking medication for type 2 diabetes, hypertension, and hypercholesterolemia
TREATMENT AND GOALS
- Was initially prescribed topical corticosteroids (TCS) while awaiting laboratory results to confirm diagnosis
- Upon diagnosis, an oral corticosteroid (OCS) was prescribed
- OCS was quickly tapered due to diabetic background and replaced with a conventional immunosuppressant
- Has experienced some improvement with a conventional immunosuppressant, but disruptive itch and bullae remain, requiring OCS reinitiation
- Wants improvement in bullous pemphigoid signs and symptoms, with potentially less OCS use
Real image of bullous pemphigoid.
Story inspired by people who suffer from bullous pemphigoid.
Recently diagnosed with bullous pemphigoid; symptomatic for 2 years
“The itch is constant, on top of everything else.”
SIGNS AND SYMPTOMS
- Noticed unexplained itch before erythematous and urticarial lesions began to appear
- Later developed bullae on the trunk
- Itch has become more intense—an 8 out of 10—and incessant
HEALTH CONSIDERATIONS
- Taking medication for gastroesophageal reflux disease (GERD), asthma, and seasonal allergies
TREATMENT AND GOALS
- Was prescribed topical corticosteroids (TCS) by primary care, but remained symptomatic and undiagnosed before referral to dermatology
- Dermatologist prescribed oral corticosteroids (OCS), which provided some control when taken at high doses
- Signs and symptoms worsen after tapering off OCS
- Primary goal is to help reduce itch
Real image of bullous pemphigoid.
Story inspired by people who suffer from bullous pemphigoid.
Diagnosing bullous pemphigoid
Thorough clinical examination and laboratory investigations are necessary, as outlined by EADV guidelines1,a
Patient history
- Date of onset
- Signs and symptoms, including itch, and how they have changed over time
- Comorbidities potentially associated with bullous pemphigoid
- Detailed drug history (within 6 months of symptom onset)
Physical examination
- Bullous presentations
- Severely pruritic, with bullae and/or erosions on erythematous, inflamed skin
- Non-bullous presentations, including:
- Eczematous and urticarial lesions
- Prurigo nodularis–like lesions
- Pruritus with or without skin lesions
Patient assessment
- Daily blister count or Bullous Pemphigoid Disease Area Index
- Direct immunofluorescence (DIF)
- Histopathology
- Enzyme-linked immunosorbent assay (ELISA)
- Indirect immunofluorescence (IIF)
Other immunopathological tests1:
- Immunoblotting and novel ELISAs
- Fluorescence overlay antigen mapping (FOAM)
- Immunochemistry
aEuropean Academy of Dermatology and Venereology (EADV) guidelines for the management of bullous pemphigoid.
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