TL;DR:
- What is Pemphigoid? A chronic autoimmune skin disease, most common in the elderly but also affects pregnant women. Non-contagious.
- Causes: Immune system disorder with autoantibodies targeting epidermal basement membrane antigens. Triggers include UV exposure and certain medications (furosemide, penicillin, etc.).
- Types:
- Bullous Pemphigoid: Most common, large blisters on skin/mucous membranes, often in the elderly.
- Scarring Pemphigoid: Affects mucous membranes (mouth, eyes, genitals), causes scarring, and can lead to vision/esophageal issues.
- Pregnancy Pemphigoid: Appears in the 2nd/3rd trimesters, starts near the umbilical area, potentially causing premature delivery or low birth weight.
- Diagnosis: Based on symptoms, history, and histopathology.
- Treatment: Primarily corticosteroids; gradual reduction reduces relapse risk. Recurrence is possible, but treatment is generally effective. Consult a dermatologist early.
Skin diseases are a huge group of conditions that sometimes produce similar symptoms, which is why it is difficult to recognize them, diagnose them correctly and thus apply effective treatment. One example of a skin ailment is pemphigoid, the most characteristic symptom of which is the presence of blisters of various sizes. Find out what you need to know about pemphigoid, what are the causes of this type of skin lesion and how it can be cured.
What is pemphigoid and what are the causes of its formation?
Pemphigoid (from the Latin Pemphigoid) is a chronic skin disease with an autoimmune basis. The condition is also sometimes referred to as bullous dermatosis. Although the condition usually appears in the elderly, it can also occur in pregnant women. Pemphigoid is not a contagious disease, so it cannot be contracted through direct contact with a sick person. 
The cause of the disease pemphigoid lies in a disorder of the immune system. In the affected person, autoantibodies acting against epidermal basement membrane antigens are present in the blood. When the autoimmune process occurs, characteristic tense blisters and erythematous and edematous lesions appear on the skin. Most often, the initiation of the autoimmune process and the appearance of pemphigoid occurs through strong exposure to UV radiation, as well as the use of certain drugs, especially those containing furosemide, penicillin, 5-fluorouracil or sulfasalazine. Pemphigoid is a chronic and recurrent disease. Sometimes the presence of the condition may indicate the development of a neoplasm located within the internal organs. Therefore, lesions of this nature always should be consulted with an experienced dermatologist. Such specialists are accepted at the OT.CO Clinic.
Pemphigoid – types and varieties of the condition.
Pemphigoid can occur under different forms and have a varied morphology, on which the treatment of this condition often depends. Among the main types of pemphigoid are:
- bullous pemphigoid,
- scarring pemphigoid,
- pemphigoid of pregnancy.
Among rare variants of pemphigoid are, for example, bullous pemphigoid, seborrheic pemphigoid, nodular pemphigoid, juvenile pemphigoid, or dyshidrotic pemphigoid.
Bullous pemphigoid – the most common variety of the condition.
Bullous pemphigoid is manifested by the presence of multiple tense, large blisters and erythematous lesions. They are also accompanied by edema. The problem affects both skin and mucous membranes. The epidermis separates from the dermis due to the action of autoantibodies, and the resulting space often accumulates bloody fluid or colorless serum. Bullous pemphigoid can also develop on skin where no redness or any symptoms are visible. Blisters occur mainly in the trunk area and areas of limb flexion, but also in the oral cavity. They are sometimes accompanied by itching and burning. Most often, this variant of the disease affects people over the age of 65.
Scarring pemphigoid, otherwise known as mucous membrane pemphigoid
Scarring pemphigoid is the second most common variety of pemphigoid, which appears mainly on the mucous membranes and skin in the region of the mouth, esophagus, conjunctiva, but also the anus or genitals. In the course of this variant of the condition, as the blisters subside, scarring and atrophy of the original tissues, i.e. mucous membranes or skin, appear. The exception to this is lesions located in the oral cavity. In the case of scarring pemphigoid, not only blisters appear on the skin, but also rum and fibrous erosions. Sometimes the condition is accompanied by exfoliative gingivitis, conjunctivitis, and with scarring and adhesions of the conjunctiva to the eyeball, there are vision problems. In extreme cases, vision loss can occur. Scarring within the esophagus, on the other hand, leads to narrowing of this part of the digestive system, which is sometimes a direct cause of cancer development.
Pemphigoid of pregnancy – a problem of the second and third trimesters.
Pemphigoid can also appear in pregnant women most often in the period between the 4th month and delivery. The condition occurs in the form of blistering and itchy erythematous lesions accompanied by swelling. The symptoms initially mainly occur in the umbilical region, and as the disease progresses, they also spread to the limbs and trunk. In the case of pemphigoid of pregnancy, there may be spontaneous entry of antibodies into the baby's bloodstream and similar blistering lesions on the body of the newborn. However, these symptoms resolve spontaneously. Sex hormones are usually responsible for the occurrence of the condition in pregnant women. After delivery, the symptoms of pemphigoid subside, although **they **may become more prominent with the next pregnancy**. Pemphigoid in pregnancy sometimes causes premature labor or is responsible for low birth weight of the baby. The condition most often occurs in pregnant women with Graves-Basedow disease.
Pemphigoid – diagnosis and treatment.
Diagnosis of pemphigoid is based on an examination of the characteristic symptoms, a history with the patient and results of the histopathological examination made on a skin specimen with a lesion. The appropriate specialist to undertake appropriate treatment in this case is a dermatologist, who usually prescribes corticosteroids, but also sulfonamides, erythromycin or tetracycline. Medications should be discontinued gradually after the condition is cured to prevent recurrence.
Unfortunately, even when pemphigoid is cured quickly, one must reckon with the risk of relapse, even after a very long period without any symptoms. This means that the disease cannot be completely cured, only controlled and brought to the extinction of recurrences as quickly as possible. Fortunately, this affliction is not stubborn to treat and responds well to the therapeutic preparations used. However, it is important to remember to consult a dermatologist as soon as possible whenever disturbing skin lesions appear.
For more details, visit the OT.CO Clinic website.
Conclusion
Pemphigoid is a chronic skin disease with diverse forms and causes. From bullous pemphigoid to pregnancy-related cases, understanding its symptoms and triggers is key. While it cannot be fully cured, prompt diagnosis and treatment help control flare-ups effectively. The condition highlights the importance of seeking expert care for any unusual skin changes. Addressing it quickly improves outcomes and minimizes complications. Always consult a dermatologist for proper guidance and management.
