Bullous Pemphigoid is a skin blistering disease that I occasionally encounter in both my The Woodlands dermatology and Conroe dermatology offices. The clinical appearance of Bullous Pemphigoid are large non-ruptured tense bullae (blisters). Unlike Pemphigus Vulgaris, the bullae in this skin disease are less fragile and are usually found intact. Also, Bullous Pemphigoid typically does not involve the oral mucosa, thus it has a much better prognosis as patients can eat and drink normally. In some patients, Bullous Pemphigoid may begin as an urticarial wheal or pruritus (itching) that soon gives rise to the bullae. Bullous Pemphigoid typically affects older patients as medicines are usually the culprit. The following medicines are commonly implicated as causing Bullous Pemphigoid: lasix, penicillamine, captopril, penicillin, sulfasalazine, enalapril, and nalidixic acid. The treatment involves removing the offending agent and immunosuppression such as prednisone.
