Diagnosis

To confirm the diagnosis, your doctor might take a small sample of the affected skin (skin biopsy) for laboratory testing.

Treatment

The goals of bullous pemphigoid treatment are to help the skin heal as quickly as possible and relieve itching. Your doctor will likely prescribe a combination of drugs that inhibit immune system activities that cause inflammation. These drugs may include:

  • Corticosteroids. The most common treatment is prednisone, which comes in pill form. But long-term use can increase your risk of weak bones, diabetes, high blood pressure, high cholesterol and cataracts. Corticosteroid ointment can be rubbed on your affected skin and causes fewer side effects.
  • Drugs that suppress the immune system. These drugs inhibit the production of your body's disease-fighting white blood cells. Examples include azathioprine (Azasan, Imuran) and mycophenolate mofetil (CellCept). Immunosuppressants are often used to help reduce the dosage of prednisone you may need.
  • Other drugs that fight inflammation. Other drugs with anti-inflammatory properties may be used alone or with corticosteroids. Examples include methotrexate (Trexall), a rheumatoid arthritis drug; tetracycline, an antibiotic; and dapsone (Aczone), a leprosy treatment.

Clinical trials

Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this disease.

Lifestyle and home remedies

If you have bullous pemphigoid, you can help take care of your condition with the following self-care strategies:

  • Avoid injury. The blisters of bullous pemphigoid and corticosteroid ointment can make your skin fragile. If a blister on your skin breaks, cover it with a dry, sterile dressing to protect it from infection as it heals.
  • Avoid sun exposure. Avoid prolonged sun exposure on any area of the skin affected by bullous pemphigoid.
  • Watch what you eat. If you have blisters in your mouth, avoid eating hard and crunchy foods, such as chips and raw fruits and vegetables, because these types of foods might aggravate symptoms.

Preparing for your appointment

You may start by seeing your primary care doctor. He or she may refer you to a doctor who specializes in skin disorders (dermatologist). You may want to bring a friend or relative to your appointment. This person, in addition to offering support, can write down information from your doctor or other clinic staff during the visit.

What you can do

Before your appointment make a list of:

  • Symptoms you've been having and for how long
  • The name and contact information of any doctor you have seen recently or see regularly
  • All medications, vitamins and supplements you take, including doses
  • Questions to ask your doctor

For bullous pemphigoid, some basic questions to ask your doctor include:

  • What's the most likely cause of my symptoms?
  • Are there other possible causes?
  • Do I need any tests?
  • How long will these skin changes last?
  • What treatments are available, and which do you recommend?
  • What side effects can I expect from treatment?

What to expect from your doctor

Your doctor will likely ask you a number of questions. Be prepared to answer the following:

  • When did these symptoms begin?
  • Where are the blisters located? Do they itch?
  • Have you observed any oozing, draining of pus or bleeding?
  • Have you recently started new medications?
  • Have you had a fever?
Aug. 04, 2017
References
  1. Murrell DF, et al. Management and prognosis of bullous pemphigoid. http://www.uptodate.com/home. Accessed Oct. 6, 2015.
  2. Bullous pemphigoid. Merck Manual Professional Version. http://www.merckmanuals.com/professional/dermatologic_disorders/bullous_diseases/bullous_pemphigoid.html?qt=pemphigoid&alt=sh. Accessed Oct. 6, 2015.
  3. Leiferman KM. Epidemiology and pathogenesis of bullous pemphigoid and mucous membrane pemphigoid. http://www.uptodate.com/home. Accessed Oct. 6, 2015.
  4. Leiferman KM. Clinical features and diagnosis of bullous pemphigoid and mucous membrane pemphigoid. http://www.uptodate.com/home. Accessed Oct. 6, 2015.
  5. Mustafa MB, et al. Oral mucosal manifestations of autoimmune skin diseases. Autoimmunity Reviews. 2015;14:930.