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TOM, Age 83Seeking help with itch and blisters
Tom, Age 83
Diagnosed with bullous pemphigoid
1 year agoThe blisters are unsightly and all over my body, with intense itch.
It's hard to deal with. -
Barbara, age 72Struggling with intense itch
Barbara, Age 72
Recently diagnosed with bullous
pemphigoid; symptomatic for 2 yearsThe itch is constant, on top of everything else.
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)
Patient assessment
- Daily blister count or Bullous Pemphigoid Disease Area Index
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
- 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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