Equis ISSN 2398-2977

Skin: bullous pemphigoid

Contributor(s): Rosanna Marsella, David Senter

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.

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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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 animalsClin Dermatol (1), 155-62 PubMed
  • George L W & White S L (1984) Autoimmune skin disease of large animalsVet Clin North Am Large Anim Pract (1), 79-86 PubMed
  • Halliwell R E (1982) Autoimmune diseases in domestic animalsJAVMA 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 animalsVet Pathol 17 (3), 257-281 PubMed.


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