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[Bullous pemphigoid].
Presse Med. 2010 Oct; 39(10):1058-65.PM

Abstract

Bullous pemphigoid is the most frequent autoimmune bullous skin disease and affects subjects who are about 80 years old. The risk factors are neurological degenerative diseases, poor Karnovski's status and some drugs (aldactone and neuroleptics). Typically, the disease consists of itching eczematous or urticarial sheets, surmounted by blisters. The blisters heal without scars. Mouth and head are rarely involved. The diagnostic is made by histological examination . It shows a subepidermal blister with some degree of dermal infiltrate with lymphocytes and eosinophils. Direct immunofluorescence reveals a linear pattern of IgG deposition along the basal membrane, which signs the diagnosis. Indirect immunofluorescence detecting anti-basal membrane antibodies is of poor diagnostic value. New tests detecting BPAg 2 antibodies by enzyme-linked immunosorbant assay (ELISA) seems to be good markers for disease activity and prognosis. Recommended treatment is topical corticosteroids (clobetasol propionate cream) for several months. It has been showed to be more effective and less dangerous than oral corticotherapy in severe forms of bullous pemphigoid. Corticosteroid sparing agents like methotrexate or mycophenolate mofetil are sometimes used because of cutaneous or systemic side effect of strong and protracted topical corticosteroid therapy. The management of these patients shall be done by specialized and coordinated staff in order to bring the best care.

Authors+Show Affiliations

Centre hospitalier du Mans, service de dermatologie, 72000 Le Mans, France. nbeneton@ch-lemans.fr

Pub Type(s)

Journal Article
Review

Language

fre

PubMed ID

20832237

Citation

Bénéton-Benhard, Nathalie. "[Bullous Pemphigoid]." Presse Medicale (Paris, France : 1983), vol. 39, no. 10, 2010, pp. 1058-65.
Bénéton-Benhard N. [Bullous pemphigoid]. Presse Med. 2010;39(10):1058-65.
Bénéton-Benhard, N. (2010). [Bullous pemphigoid]. Presse Medicale (Paris, France : 1983), 39(10), 1058-65. https://doi.org/10.1016/j.lpm.2010.03.028
Bénéton-Benhard N. [Bullous Pemphigoid]. Presse Med. 2010;39(10):1058-65. PubMed PMID: 20832237.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Bullous pemphigoid]. A1 - Bénéton-Benhard,Nathalie, Y1 - 2010/09/15/ PY - 2009/07/25/received PY - 2010/03/04/revised PY - 2010/03/30/accepted PY - 2010/9/14/entrez PY - 2010/9/14/pubmed PY - 2010/11/3/medline SP - 1058 EP - 65 JF - Presse medicale (Paris, France : 1983) JO - Presse Med VL - 39 IS - 10 N2 - Bullous pemphigoid is the most frequent autoimmune bullous skin disease and affects subjects who are about 80 years old. The risk factors are neurological degenerative diseases, poor Karnovski's status and some drugs (aldactone and neuroleptics). Typically, the disease consists of itching eczematous or urticarial sheets, surmounted by blisters. The blisters heal without scars. Mouth and head are rarely involved. The diagnostic is made by histological examination . It shows a subepidermal blister with some degree of dermal infiltrate with lymphocytes and eosinophils. Direct immunofluorescence reveals a linear pattern of IgG deposition along the basal membrane, which signs the diagnosis. Indirect immunofluorescence detecting anti-basal membrane antibodies is of poor diagnostic value. New tests detecting BPAg 2 antibodies by enzyme-linked immunosorbant assay (ELISA) seems to be good markers for disease activity and prognosis. Recommended treatment is topical corticosteroids (clobetasol propionate cream) for several months. It has been showed to be more effective and less dangerous than oral corticotherapy in severe forms of bullous pemphigoid. Corticosteroid sparing agents like methotrexate or mycophenolate mofetil are sometimes used because of cutaneous or systemic side effect of strong and protracted topical corticosteroid therapy. The management of these patients shall be done by specialized and coordinated staff in order to bring the best care. SN - 2213-0276 UR - https://www.unboundmedicine.com/medline/citation/20832237/[Bullous_pemphigoid]_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0755-4982(10)00426-4 DB - PRIME DP - Unbound Medicine ER -