Bullous pemphigoid - causes, symptoms, diagnosis, treatment, photo
- 15 Aug 14:45
- Disease Of The Skin
Bullous pemphigoid( second name - Lever's disease) is a chronic defeat of the skin with the formation of blistering. The disease is benign.
Most commonly, bullous pemphigoid develops in the elderly, the average age of the patients is -65 years. However, sometimes thisdisease is diagnosed both in young and even in children.
Symptoms of bullous pemphigoid have much in common with the usual vesicular, however, the mechanism of development of these diseases is different.
- 1 Causes of development of
- 2 Clinical picture of
- 3 Methods of diagnosis
- 4 Treatment of
- 4.1 Treatment of folk remedies
- 5 Prevention and prognosis
- 6 Photo
Causes of development of
The exact causes of pemphigoid development in bullous form are unknown. Although in the recent past, scientists have been able to obtain evidence that an important role in the development of this dermatosis is played by autoimmune factors.
Specific antibodies to the basal membrane of the skin have been detected in the blood of Lever's disease and fluid filling the bubbles. Moreover, the more active the inflammatory process develops, the higher the antibody titer.
It is believed that bullous pemphigoid is a marker for the development of oncological diseases. Therefore, all patients with Lever's disease are referred for examination in order to exclude oncology. Also, some scientists include bullous pemphigoid to a group of diseases like bullous epidermolysis.
Clinical picture of
Most commonly, bullous pemphigoid occurs in the classical form. Typically, the pathological process covers the skin of the trunk and extremities. Less commonly in the area of defeat is the skin of the head, face and large natural folds. With Lever's disease, rashes tend to be symmetrical.
The main element of the rash is bubbles and vesicles, filled with transparent( rarely-hemorrhagic) content. Bubbles have dense tensioned tire covers. Rash can be located on the outside of a healthy skin, but more often it appears on the background of redness. The appearance of bubbles may be accompanied by the emergence of papular and urticaria elements as with sarcoidosis.
Bleeds formed in the Lever's disease exist for several days, then spontaneously open with the formation of erosive-ulcer defects. Erosion epithelizes too quickly, so for this disease the formation of crust is uncharacteristic.
Approximately 20% of patients in the first stage of the bullous pemphigoid rash appear on the mucous membrane of the mouth, as the disease progresses, the skin is drawn into the process. As a consequence of rash on the mucosa, a disease like leukoplakia may develop. When bullous pemphigoid, the appearance of rashes on mucous membranes of the nose, throat, genital and conjunctiva is possible in exceptional cases.
During the disease, two periods can be distinguished:
Prodromal period can last for several months, and sometimes even for several years. At this time, patients are concerned about itching, the appearance of nonspecific( papular or urticaria) rashes. No other Lever disease is noted, therefore, at this stage, it is very rare to correctly diagnose. Patients are trying to treat chronic eczema, prurigo, Dühring's dermatitis, cholinergic urticaria and other itchy dermatoses. However, long-term results are not taken measures.
Often, only with the onset of the bullous phase of Lever's disease and the appearance of blisters, I manage to put the correct diagnosis.
Subjective sensations in Lever's disease are expressed by the appearance of itching. Fewer patients complain of pain and feverish conditions when infected with chicken pox, etc.infectious diseases. In depleted patients, especially in the elderly, Lever's disease is often accompanied by loss of appetite, progressing to a general weakness. Bullous pemphigoid is a long-term disease that is characterized by alternation of relapses and remissions.
Diagnosis in the bullous period of the Lever's disease is not a problem and is based on specific clinical manifestations of the disease - the appearance of tense bubbles, as in the case of Ritter's disease, erosion forms in the rapid epithelial process.
Nicholas' syndrome( a specific sign of some diseases characterized by epigerminal laceration) with pemphigoid negative.
At the non-specific clinical course of Lever's disease, an important diagnostic value becomes the histological examination of the material taken from the places of injury. During histological studies, it is possible to detect vacuoles and bubbles located in the subepidermal region. In the fluid filling the bubbles, there are histiocytic elements, lymphocytes, eosinophils.
Pemphigoid in bullous form should be distinguished from true, erythema multiforme and other diseases, which are characterized by bullous rashes.
Lever's disease should be selected individually, treatment of pemphigoid should be comprehensive. The choice of the treatment scheme for bullous pemphigoid depends on the prevalence of the process, the severity of the course of the process, the general condition of the patient, the detected concomitant diseases.
The main means of treating bullous pemphigoid are preparations containing glucocorticosteroids. As a rule, at the first stage of the treatment of Lever's disease, administration of 60-80 mg of the drug in terms of prednisone per day is prescribed. Then a smooth adjustment of the dose is made in the direction of reduction. In some cases it is necessary to prescribe drugs in higher doses.
In addition, for the treatment of bullous pemphigoid used immunosuppressors and cytostatics - Ciclosporin A, azathioprine, Cyclophosphamide, etc.
There is evidence of a good therapeutic effect in the treatment of pemphigoid from the complex application of glucocorticosteroids and cytostatics. For the treatment of Lever's disease, systemic enzymes may be additionally administered, the dose of which depends on the severity of the symptoms.
Externally, ointments containing glucocorticosteroids and aniline dyes, for example, furcocine, are used for the treatment of bullous pemphigoid.
Treatment with folk remedies
Before using phytotherapy for the treatment of bullous pemphigoid it is necessary to consult a doctor who is monitoring the course of the disease.
- In Lever disease, it is recommended to take 30 drops of Eleutherococcus infusion twice a day.
- In the treatment of bullous pemphigoid can help collect grasses. It is necessary to take 50 grams of Japanese sophora( fruit), eucalyptus( leaves), birch buds, coagulos( rhizomes) of nettle herbs, shepherd's bag and a tree. To brew two spoons of a mixture with a glass of boiling water in the evening. Infuse overnight. Urume infusion strain, divided into three portions. Drink during the day.
- For external treatment of bullous pemphigoid manifestations, juice squeezed out of aloe or nettle leaves can be used. In the juice it is necessary to moisten the segment of bandage and apply to bubbles or erosion. At the top, close the compress film and fix it with a bandage or a plaster.
Prevention and prognosis
Preventive measures to prevent the development of bullous pemphigoid have not been developed. The prognosis of a well-timed treatment is good.
However, it should not be forgotten that Lever's disease is often a secondary illness and is a marker for oncology. Therefore, when the bullous pemphigoid is detected, the patient should be directed to a comprehensive examination to exclude the oncological diagnosis.