[Bullous pemphigoid: diagnostics and new therapeutic strategies]

Bullous pemphigoid, the most frequent bullous autoimmune dermatosis of the adult, typically presents as disseminated tense blisters on normal or erythematous skin. The diagnosis can be confirmed by direct and indirect immunofluorescence, the detection of circulating autoantibodies against the basement membrane proteins collagen XVII/BP180 and BP230, and histopathology. Autoantibody reactivity against collagen XVII can be measured by ELISA and correlates with disease activity. The ELISA therefore provides a useful tool for monitoring disease activity. Treatment of bullous pemphigoid usually consists of topical and / or systemic steroids in combination with immunosuppressive agents. The intensity of skin involvement and the concurrent diseases and medications of the patient must be considered when selecting a certain treatment. Interdisciplinary cooperation between general practitioners, internists and other specialists facilitates the optimal adaptation of the medication and the early discovery of potential side effects.