Skin: bullous pemphigoid
Introduction
- Bullous pemphigoid (BP) is a rare auto-immune subepithelial blistering dermatosis.
- Cause: usually idiopathic but it could be triggered by drug or other antigen exposure.
- Signs: ulcers, blisters.
- Diagnosis: histopathology.
- Treatment: glucocorticoids.
Presenting signs
- Depression.
- Anorexia.
- Ulcers in the oral cavity.
- Ulcers in frictional areas.
- Intact blisters.
Age predisposition
- It can occur at any age.
Public health considerations
- Not a contagious disease.
Cost considerations
- Expensive due to the intensive treatment.
Pathogenesis
Etiology
- Skin-fixed and circulating IgG auto-antibodies target bullous pemphigoid antigens (BP ag1, and BPAg 2).
- After antibody binding complement fixation and activation occurs → activation of mast cells and the release of chemokines which recruit inflammatory cells in the area, eg neutrophils and eosinophils.
- The release of enzymes from these cells → the disruption of the basement membrane and formation of bullae.
Pathophysiology
- Auto-antibodies trigger an inflammatory response in the basement membrane leading to subepidermal clefting.
- As blisters are very fragile and transient, ulcers are the most common manifestation of this disease.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Olivry T, Borrillo A K, Xu L et al (2000) Equine bullous pemphigoid IgG autoantibodies target linear epitopes in the NC16A ectodomain of collagen XVII (BP180, BPAG2). Vet Immunol Immunopathol 73 (1), 45-52 PubMed.
- Scott D W (1987) Pemphigoid in domestic animals. Clin Dermatol 5 (1), 155-62 PubMed.
- George L W & White S L (1984) Autoimmune skin disease of large animals. Vet Clin North Am Large Anim Pract 6 (1), 79-86 PubMed.
- Halliwell R E (1982) Autoimmune diseases in domestic animals. JAVMA 181 (10), 1088-1096 PubMed.
- Scott D W, Wolfe M J, Smith C A & Lewis R M (1980) The comparative pathology of non-viral bullous skin diseases in domestic animals. Vet Pathol 17 (3), 257-281 PubMed.