Bullous pemphigoid is an autoimmune pruritic skin disease preferentially in older people, aged over 60, that may involve the formation of blisters (bullae) in the space between the epidermal and dermal skin layers. The disorder is a type of pemphigoid. It is classified as a type II hypersensitivity reaction, with the formation of anti-hemidesmosome antibodies.
Pemphigus and bullous pemphigoid are autoantibody-mediated blistering skin diseases. In pemphigus, keratinocytes in epidermis and mucous membranes lose cell-cell adhesion, and in pemphigoid, the basal keratinocytes lose adhesion to the basement membrane. Pemphigus lesions are mediated directly by the autoantibodies, whereas the autoantibodies in pemphigoid fix complement and mediate inflammation. In both diseases, the autoantigens have been cloned and characterized; pemphigus antigens are desmogleins (cell adhesion molecules in desmosomes), and pemphigoid antigens are found in hemidesmosomes (which mediate adhesion to the basement membrane).
Bullous pemphigoid د اتومیمون بیلوس ترټولو عام ناروغي ده چې په عمومي ډول په لویانو اغیزه کوي. په وروستیو لسیزو کې د قضیو زیاتوالی د عمر لرونکي نفوس، د مخدره توکو پورې اړوند پیښو، او د حالت د غیر بیل ډول ډولونو لپاره د تشخیصي میتودونو سره تړاو لري. په دې کې د T حجرو په غبرګون کې نیمګړتیا او د اتو انټي باډي (IgG او IgE) تولید شامل دي چې ځانګړي پروټینونه (BP180 او BP230) په نښه کوي، چې په پایله کې د پوستکي ملاتړي جوړښت سوزش او ماتیږي. په نښو کې معمولا په بدن او غړو باندې د پړسوب ، خارښ لرونکی داغونه شامل دي چې د مغز غشا نادره ښکیلتیا سره. درملنه په ابتدايي توګه په قوي سیمه ایز او سیسټمیک سټرایډونو باندې تکیه کوي، د وروستیو مطالعاتو سره چې د اضافي درملنې ګټې او خوندیتوب په ګوته کوي (doxycycline, dapsone, immunosuppressants) ، موخه یې د سټرایډ کارولو کمول دي. Bullous pemphigoid is the most frequent autoimmune bullous disease and mainly affects elderly individuals. Increase in incidence rates in the past decades has been attributed to population aging, drug-induced cases and improvement in the diagnosis of the nonbullous presentations of the disease. A dysregulated T cell immune response and synthesis of IgG and IgE autoantibodies against hemidesmosomal proteins (BP180 and BP230) lead to neutrophil chemotaxis and degradation of the basement membrane zone. Bullous pemphigoid classically manifests with tense blisters over urticarial plaques on the trunk and extremities accompanied by intense pruritus. Mucosal involvement is rarely reported. High potency topical steroids and systemic steroids are the current mainstay of therapy. Recent randomized controlled studies have demonstrated the benefit and safety of adjuvant treatment with doxycycline, dapsone and immunosuppressants aiming a reduction in the cumulative steroid dose and mortality.