Bullous disease PEMPHIGUS: Signs, causes and treatment

The article was consulted with Specialist Doctor I Le Thi Thu Hang - Dermatologist - Department of Medical Examination & Internal Medicine - Vinmec Hai Phong International General Hospital.

Bullous pemphigus is an autoimmune bullous skin disease, chronic progressive disease, rarely with mucosal involvement.
The disease is common in the elderly (from 60 years of age and older). The disease is equally common in both sexes and there is no racial difference. Rarely in children.
According to research, bullous pemphigus is associated with human leukocyte antigen (HLA). Pemphigus bullous disease is more common in elderly people with neurological disease , stroke , Parkinson's disease .
In some other patients, bullous pemphigoid has been associated with visceral malignancies. Several other factors can also predispose to bullous pemphigus such as trauma, infection, medication.

The first sign of bullous pemphigoid is usually a lot of itching, a lot of scratching, leaving many scratches. The itching can last for months or even years before the blisters appear. Skin lesions in bullous pemphigoid manifest in a variety of ways, such as:
An erythematous rash persists for several weeks before the appearance of the bullae. Areas of skin with eczema-like lesions, with circular eczema. The skin is red in patches, itchy, like urticaria. Ring-shaped skin lesions. Small blisters appear, then itchy papules. The vesicles are 1 to a few centimeters in diameter, round, bland, contain fluid inside, are fragile, may have a lemon-yellow discharge, or have bloody or purulent fluid. Then the blisters burst, leaving circular slides, crusting with secretions, which when healed, leave pigmented edges, leaving no scars. Post-inflammatory hyperpigmentation. Presence of milia lesions in areas of healed skin. Some patients are diagnosed with pemphigoid despite the absence of bullous lesions (non-bullous pemphigoid or pre-bullous pemphigoid). Skin lesions can appear anywhere on the body.

If left for a long time, without early and timely treatment, the affected areas will spread around, the patient has a large lesion area, the doctor may appoint an inpatient hospital to take care of the cysts. water, skin abrasions.
Topical treatment:
Strong topical steroids Medium topical steroids and moisturizers help to relieve itching, dry skin. Systemic steroids. Antibiotics for secondary infections. Cyclic antibiotics: tetracycline, doxycycline, Nicotinamide, Dapsone, Methotrexate, Azathioprine, Mycophenolate mofetil, Intravenous Immunoglobulin, Rituximab In addition, people with bullous pemphigoid during treatment should pay attention to:
Need to rehydrate and electrolytes for body . Improve physical condition and resistance by using vitamins of groups B and C, combined with application of adequate nutrition, for patients to eat in small meals. Use corticosteroids at appropriate doses for each patient to control the disease.

Hygiene to minimize superinfection, combined with the use of topical medications combined with oral medications to help soothe the skin. Topical drugs such as castellani solution, milian, glycerin borate, antibiotic ointment, corticoid ointment can be used to fight infections and heal scars. In severe cases, the patient must lie on a bed of powder to prevent infection and avoid skin abrasion. Patients should avoid trauma, scratching the damaged areas, acne growth because blisters may appear on the damaged skin. When there is damage to the mouth, only soft foods should be eaten. Properly care for the diseased area under the guidance of medical staff to avoid secondary infections. Examination and treatment as directed by the doctor. Early detection and treatment will make treatment easier. Therefore, when there are symptoms of bullous Pemphigoid disease, it is necessary to quickly go to the hospital, medical center and reputable dermatology clinic for timely examination and treatment.
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