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Skin Diseases and Disorders01:23

Skin Diseases and Disorders

Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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Skin Cancer

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Peptic Ulcer Disease I: Introduction

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Inflammatory Bowel Disease I: Ulcerative Colitis

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Smallpox01:24

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Bullous pemphigoid.

Denise Miyamoto1, Claudia Giuli Santi1, Valéria Aoki2

  • 1Division of Dermatology, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP), Brazil.

Anais Brasileiros De Dermatologia
|May 16, 2019
PubMed
Summary
This summary is machine-generated.

Bullous pemphigoid (BP) is a common autoimmune blistering disease in the elderly. Diagnosis involves skin biopsy, immunofluorescence, and autoantibody testing, with treatments including steroids and newer adjuvant therapies.

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Area of Science:

  • Immunodermatology
  • Autoimmune diseases
  • Geriatric medicine

Background:

  • Bullous pemphigoid (BP) is the most common autoimmune bullous disease, predominantly affecting the elderly.
  • Rising incidence is linked to an aging population, drug-induced cases, and improved diagnosis of non-bullous presentations.
  • Pathogenesis involves a dysregulated immune response targeting hemidesmosomal proteins (BP180, BP230), leading to blistering.

Purpose of the Study:

  • To provide a comprehensive overview of bullous pemphigoid.
  • To detail diagnostic criteria and current therapeutic strategies.
  • To highlight associated comorbidities and mortality rates.

Main Methods:

  • Diagnosis relies on histopathology (eosinophilic spongiosis, subepidermal detachment), immunofluorescence (IgG/C3 deposition), and serology (ELISA for anti-BP180/BP230 autoantibodies).

Main Results:

  • Classically presents with tense blisters and intense pruritus; mucosal involvement is rare.
  • Elderly patients often have comorbidities, including neurological disorders and increased thrombotic risk, with a significant 1-year mortality rate (23%).

Conclusions:

  • Treatment requires tailoring to clinical status and disease severity, with topical/systemic steroids as primary therapy.
  • Adjuvant therapies like doxycycline, dapsone, and immunosuppressants show promise in reducing steroid dependence and mortality.