PEMPHIGOID

Linear IgG is deposited on the junction between epidermis and dermis. Epidermis detaches from dermis and subepidermal blister occurs. The roof of the blister is made by whole epidermis. So, the blister is not easily open and tight, can reach to very large diameters.

1. Bullous Pemphigoid

Especially people above 70 years old are involved. Provoking factors are drugs such as furocemide, 5-fluorouracil and penicilline, and malignancies. Firstly erythema, papule with edema, vesicles or blisters appear on a scar belongs a vaccine or burn, or on umbilicus as a localized phase. Wrong diagnosis may be eczema, urticaria, erythema multiforme at this phase because of the existence of pruritus. After several months the disease turn into generalized phase. Solitary or grouped large blisters arranged as a circle on body and/or extremities. Prognosis is better than pemphigus and 40 mg/day prednisolone is useful and sufficient for the patients above 70 years old. Steroids may be used higher doses for the patient younger than 70 years old.

2. Cicatricial Pemphigoid

Females are involved frequently. Mainly orifices and around of orifices are involved. So, the disease is mainly localized to head. Attacks and remissions while remain scars after attacks are seen. Scars become severe after every attack and lead to function disturbances. Eye involvement may lead to blindness. Local or systemic steroids, cytostatics or dapsone may be tried, but responses are unpredictable.