Bullous Pemphigoid - Diagnosis and Management Summary Pathophysiology: Autoantibody-mediated damage to epithelial basement membrane -> separation of epidermis from dermis Clinical Signs/Symptoms/Exam findings: - Prodrome: pruritic, inflammatory plaques (may resemble eczema or urticaria) weeks to months bullous phase - Bullous phase: tense 1-3 cm bullae, often pruritic. Most commonly located on trunk, flexural surfaces, and axillary and inguinal folds - Erosions and crusts at sites of ruptured bullae - Mucous membrane involvement with blisters/erosions in ~20% Management: 1. High-potency topical steroids 2. Systemic glucorticoids if 1) not feasible CMC IM Residency @CMC_IM #Bullous #Pemphigoid #Diagnosis #Management #dermatology
