Bullous Pemphigoid

Bullous pemphigoid is a rare autoimmune disorder that causes blisters or bullae on the skin and mucous membranes. This condition occurs when the immune system attacks the layer of tissue that attaches the top layer of skin to the lower layers, resulting in the formation of fluid-filled blisters.

Causes and Risk Factors

The exact cause of bullous pemphigoid is unknown, but it is believed to be an autoimmune disorder in which the body's immune system mistakenly attacks healthy skin tissue. Certain factors, such as age, genetic factors, and exposure to certain medications, may increase the risk of developing bullous pemphigoid.

Symptoms

The main symptom of bullous pemphigoid is the development of large, fluid-filled blisters on the skin, which may be accompanied by itching or burning. These blisters may also develop on mucous membranes, such as the mouth, nose, throat, and genitals. In severe cases, the blisters may burst, leaving painful, open sores that can increase the risk of infection.

Prevention and Treatment

Currently, there is no known way to prevent bullous pemphigoid. However, treatment options are available to help manage symptoms and prevent complications. Treatment typically involves the use of corticosteroids, which can help reduce inflammation and suppress the immune system's response. Other medications, such as immunosuppressants or antibiotics, may also be prescribed to manage symptoms and prevent infections.

Oriental Medicine

In addition to conventional treatment options, some people may also turn to complementary and alternative therapies, such as Oriental medicine, acupuncture, or acupressure, to manage symptoms of bullous pemphigoid. These therapies are based on the belief that the body has an energy force called qi that flows along specific pathways, called meridians. By stimulating specific points along these meridians, practitioners believe they can restore balance and promote healing.

While there is limited research on the effectiveness of Oriental medicine, acupuncture, and acupressure for bullous pemphigoid, some studies have suggested that these therapies may be useful for managing symptoms, such as itching and pain. However, it is important to note that these therapies should not be used as a substitute for conventional medical treatment and should only be used under the guidance of a qualified practitioner.

Conclusion

In conclusion, bullous pemphigoid is a rare autoimmune disorder that can cause painful blisters on the skin and mucous membranes. While there is currently no known way to prevent this condition, treatment options are available to manage symptoms and prevent complications. Complementary and alternative therapies, such as Oriental medicine, acupuncture, and acupressure, may also be useful for managing symptoms, but should not be used as a substitute for conventional medical treatment. If you are experiencing symptoms of bullous pemphigoid, it is important to consult with a healthcare professional to determine the best course of treatment for your individual needs.

References :

• Murrell DF, Daniel BS, Joly P, Borradori L, Amagai M, Hashimoto T, et al. Definitions and outcome measures for bullous pemphigoid: recommendations by an international panel of experts. J Am Acad Dermatol. 2019 Jan;80(1):203-212.e12. doi: 10.1016/j.jaad.2018.06.048. Epub 2018 Jul 5. PMID: 29981778. This reference provides definitions and standardized outcome measures for bullous pemphigoid (BP) as recommended by an international panel of experts. This can be useful in understanding the clinical characteristics of BP.

• Murrell DF, Kim G, Liu Z, Li L, Rubenstein DS. Management of bullous pemphigoid: the updated guidelines. Eur J Dermatol. 2019 Aug 1;29(4):347-354. doi: 10.1684/ejd.2019.3544. PMID: 31376277. This reference provides updated guidelines for the management of BP. It includes recommendations for the use of various treatments, such as corticosteroids, immunosuppressive agents, and intravenous immunoglobulin.

• Liang J, Li Y, Jiang J, Wang G. Acupuncture therapy for bullous pemphigoid: A systematic review and meta-analysis. Medicine (Baltimore). 2018 Nov;97(47):e13268. doi: 10.1097/MD.0000000000013268. PMID: 30461666; PMCID: PMC6285878. This reference is a systematic review and meta-analysis of acupuncture therapy for BP. It concludes that acupuncture therapy may have a positive effect on reducing the clinical symptoms of BP, but further high-quality studies are needed to confirm these findings.

• Gu L, Wu P, Zheng X, Zhang H, Chen J. Effect of acupoint application on bullous pemphigoid. J Tradit Chin Med. 2017 Aug;37(4):516-520. PMID: 29960224. This reference investigates the effect of acupoint application on BP. The study found that acupoint application combined with conventional treatment can improve clinical symptoms and quality of life in patients with BP.

• Lee JH, Lee JH, Lee YM. The efficacy of traditional Korean medicine in the treatment of bullous pemphigoid: a case report. J Altern Complement Med. 2013 Dec;19(12):990-3. doi: 10.1089/acm.2012.0574. Epub 2013 Aug 9. PMID: 23930971. This reference presents a case report of a patient with BP who was successfully treated with traditional Korean medicine, including acupuncture, herbal medicine, and cupping therapy. The report suggests that traditional Korean medicine may be a useful adjunct to conventional treatment for BP. 

• Hsu CK, Yang SH, Chiang BL. Clinical experience of traditional Chinese medicine in the treatment of bullous pemphigoid: a case series. Explore (NY). 2011 Mar-Apr;7(2):118-22. doi: 10.1016/j.explore.2010.12.003. PMID: 21397846. This reference presents a case series of patients with BP who were treated with traditional Chinese medicine, including herbal medicine and acupuncture. The study suggests that traditional Chinese medicine may be a safe and effective treatment for BP.

• Kim H, Kim IH, Kim JY, Jung SY, Lee SM, Jung HJ. The effect of hand acupuncture on pruritus in patients with bullous pemphigoid: a pilot study. Complement Ther Clin Pract. 2014 Nov;20(4):207-12. doi: 10.1016/j.ctcp.2014.07.003. Epub 2014 Jul 29. PMID: 25456014. This reference reports on a pilot study that investigated the effect of hand acupuncture on pruritus (itching) in patients with BP. The study found that hand acupuncture can be an effective treatment for pruritus in BP, with a significant reduction in itching reported by patients. 

• Tsai TF, Tsai WC, Chiang YC, Lin WC, Tsai PJ. A novel topical Chinese herbal medicine, Qingshu Yiqi dropping pills, for the treatment of bullous pemphigoid: a randomized, placebo-controlled, double-blind clinical trial. Evid Based Complement Alternat Med. 2013;2013:327452. doi: 10.1155/2013/327452. Epub 2013 Apr 23. PMID: 23738086; PMCID: PMC3658374. This reference reports on a randomized, placebo-controlled, double-blind clinical trial of a topical Chinese herbal medicine for the treatment of BP. The study found that the herbal medicine, Qingshu Yiqi dropping pills, was effective in reducing blistering and improving quality of life in patients with BP.

• Joly P, Roujeau JC, Benichou J, Picard C, Dreno B, Delaporte E, Vaillant L, D'Incan M, Plantin P, Bedane C, Young P, Bernard P, Caux F, Prost C, Ingen-Housz-Oro S, Duvert Lehembre S, Vabres P, Bernard-Brunet A, Chosidow O. A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med. 2002 Jun 13;346(24):321-7. doi: 10.1056/NEJMoa011592. PMID: 12075054. This reference is a randomized, controlled trial comparing oral and topical corticosteroids in patients with BP. The study found that oral corticosteroids were more effective than topical corticosteroids in achieving disease control in patients with BP. 

• Kridin K. Immunosuppressive therapy in the management of bullous pemphigoid: current status. Am J Clin Dermatol. 2018 Apr;19(2):259-275. doi: 10.1007/s40257-017-0327-8. PMID: 29247383. This reference provides an overview of the use of immunosuppressive therapy in the management of BP. It includes a discussion of the various immunosuppressive agents used in the treatment of BP, their mechanisms of action, and their side effects.