Bullous pemphigoid

Diagnosis

To confirm the diagnosis, your doctor may order blood tests and take a small sample of the affected skin (skin biopsy) for laboratory testing.

Your doctor may refer you to a doctor who specializes in conditions of the skin (dermatologist) or eyes (ophthalmologist), depending on your signs and symptoms and the results of your lab tests.

Treatment

Treatment is focused on healing the skin and relieving itching, while minimizing adverse side effects of medications. Your doctor will likely prescribe one or a combination of the drugs:

• Corticosteroids. The most common treatment is prednisone, which comes in pill form. But long-term use can increase your risk of weak bones, diabetes, high blood pressure, high cholesterol and infection. Corticosteroid ointment can be rubbed on your affected skin and causes fewer side effects.
• Steroid-sparing drugs. These drugs affect the immune system by inhibiting the production of your body's disease-fighting white blood cells. Examples include azathioprine (Azasan, Imuran) and mycophenolate mofetil (CellCept). If your signs and symptoms involve the eyes or upper digestive tract, the drug rituximab may be used if other approaches haven't helped.
• Other drugs that fight inflammation. An example is methotrexate (Trexall).

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition.

Lifestyle and home remedies

If you have bullous pemphigoid, you can help take care of your condition with the following self-care strategies:

• Wound care. Follow your doctor's advice for daily care of blisters.
• Limit activities if needed. Blisters on the feet and hands can make it difficult to walk or to go about daily activities. You may need to change your routine until the blisters are under control.
• Avoid sun exposure. Avoid prolonged sun exposure on any area of the skin affected by bullous pemphigoid.
• Dress in loosefitting cotton clothes. This helps protect your skin.
• Watch what you eat. If you have blisters in your mouth, avoid eating hard and crunchy foods, such as chips and raw fruits and vegetables, because these types of foods might aggravate symptoms.

Preparing for your appointment

You may start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist). You may want to bring a friend or relative to your appointment. This person, in addition to offering support, can write down information from your doctor or other clinic staff during the visit.

What you can do

Before your appointment make a list of:

• Symptoms you've been having and for how long
• The name and contact information of any doctor you have seen recently or see regularly
• All medications, vitamins and supplements you take, including doses
• Questions to ask your doctor

For bullous pemphigoid, some basic questions to ask your doctor include:

• What's the most likely cause of my symptoms?
• Are there other possible causes?
• Do I need any tests?
• How long will these skin changes last?
• What treatments are available, and which do you recommend?
• What side effects can I expect from treatment?

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be prepared to answer the following:

• When did these symptoms begin?
• Where are the blisters located? Do they itch?
• Have you observed any oozing, draining of pus or bleeding?
• Have you recently started new medications?
• Have you had a fever?