Bullous Pemphigoid and Pemphigus Vulgaris

Bullous pemphigoid usually causes very itchy, tense blisters because the immune system attacks structures deeper at the skin junction. Pemphigus vulgaris more often causes fragile blisters and painful erosions, commonly in the mouth, because antibodies disrupt connections between surface skin cells. Both can resemble other causes of skin blisters. A dermatologist may use a biopsy from affected and nearby skin, together with laboratory testing, to identify the pattern of immune activity.

Arrange prompt assessment for repeated blisters, skin peeling, or mouth sores. Until reviewed, avoid picking or bursting lesions, wash gently, and protect open skin with non-stick coverings. Treatment may include topical corticosteroids, oral corticosteroid treatment, or other medicines that reduce immune activity. Antibiotics are not a substitute for diagnosis; they may be used only when a clinician identifies a bacterial infection. Keep follow-up appointments because healing, nutrition, and medicine effects need review.

Seek urgent care for widespread erosions, fever, pus, rapidly worsening pain, trouble eating or drinking, or reduced urine. Eye involvement, severe mouth pain, swallowing difficulty, breathing symptoms, or facial swelling require immediate assessment. These problems can cause fluid loss or interfere with vision and nutrition.

Ask whether the pattern fits bullous pemphigoid or pemphigus vulgaris, which tests are needed, how to protect mouth or eye surfaces, and how treatment will be monitored.