ABSTRACT
Bullous pemphigoid is one of the subepidermal immune-mediated bullous disorders. There is some overlap between these disorders, which will become apparent in the description of the clinical, pathological and pathogenetic mechanisms and treatment. Bullous pemphigoid is mainly a disease of the elderly, most commonly seen in persons over 60 years. However, it may occur in young persons including children. It is the most common immuno-bullous disorder in Western Europe. There is no strong familial association in pemphigoid. Several drugs have been implicated in precipitating the disease, including penicillins, sulfonamides, penicillamine and frusemide. These drugs have been claimed to affect the immune system and allow induction of an autoimmune disease. Direct immunofluorescent studies should be performed on perilesional skin, as the immunoglobulins may be destroyed by enzymes released from the cellular infiltrate.
