WHAT IS BULLOUS PEMPHIGOID ?

 BULLOUS PEMPHIGOID 

Bullous pemphigoid is a rare skin condition that causes blisters on your skin . It 's an autoimmune disease . certain medications may trigger  bullous pemphigoid , but healthcare providers aren't sure exactly cause it . It can be well managed with medications. 

Bullous  pemphigoid is a  rare skin condition that causes, itchy , hive - like welts or fluids - filled blisters . Blisters may occur anywhere , but often develop  on flexual  areas of your skin , such as under your armpits , around your groin or on your stomach . In some cases, blisters also form on mucous membranes, including your mouth , tongue , throat , esophagus and / or eyes.


BULLOUS  PEMPHIGOID PICTURES  :
























HOW TO TREAT BULLOUS PEMPHIGOID ?

Treatments include topical steroids such as clobetasol , and halobetasol which in some studies have proven to be equally  effective as systemic or pill, therapy and somewhat safar. In difficulrt to manage or widespread cases, systemic prednisone and powerful steroid free immunosuppressant  medications such as methotrexate , azathiprine  may be approprite . some of these medications  have the potential for severe adverse effects such as  kidneyand liver  damage , increased susceptibility  to infections , and bone marrow suppression . 
10 randomized controlled trials showed that oral steroids  are safe and effective for treatments of moderate bullous pemphigoid . Mediated pemphigoid can often be difficult to treat even with usually effective medications such as rituximab . 



WHAT ARE THE TREATMENT DIET OF BULLOUS PEMPHIGOID ?



FOODS TO AVOID FOR PEMPHIGUS :

Pemphigus is an autoimmune disease that is most prevalent in adults over the age of 50 . Symptoms include blistering throughout the mucous membranes of the body . Blistering most often occurs in the mouth and throat , but can also occur in the nose, around the eyes , and in the membranes of the genital region . Antibiotics drugs are used to manage the condition and to prevent infection . Certain  foods can aggravate your condition .

1. ACIDIC AND SPICY FOODS  
Acidic and spicy foods should be avoided when you have an outbreak of pemphigus blisters , the acid , papain or other heat inducing chemicals in these foods can be very painful when the food comes in contact with your oral lesions . Citrus fruits and juices , tomatoes products , hot peppers , salsa , curries and other spicy items are just some of the foods you may want to avoid during this time . 

2. ONION AND GARLIC FAMILY 
Foods in the onion and garlic family, including chives , leeks and shallots, may actually  contribute to pemphigus in some cases. When people who had blistering of the skin consistent with pemphigus eliminated these vegetables from their diets , they experienced a  decrease in symptoms . when onion , garlic and related foods were reintroduced , the skin condition worsened . 

3. TANNINS 
Tannins are a substance found in a wide variety of dark - colored foods and drinks , including red wine , cola soft drinks , berries, grapes , eggplant , as well as bananas , avacados and apples and pears. To avoid all foods that contain  tannins depending on your  individual condition and the tannin level of the foods . 

4. PHENOLS 
Phenol is another term for carbolic acid, a compound that is naturally occuring in some foods and added to others in synthetic form . Artifical sweeteners as well as tomatoes , potatoes and mangoes contain pinene another type of phenol , and can worsen pemphigus symptoms . 

5. HARD AND CRUSTY FOODS 
Foods that are hard, sharp or crusty such as potato chips or crusty breads , should be avoided  during a period of active blistering .  Sharp edged foods that scrape against your mouth and throat as you eat can tear blister and other healing erosions open , leaving you in more pain and susceptible to infection . 


WHAT ARE THE TRIGGER FACTORS OF BULLOUS PEMPHIGOID?




1. DRUGS 
BP has been frequently associated with  the assumption of systemic therapies . The putative drugs are antibiotics , beta blockers , non steroidal anti - inflammatory drugs , diuretics and , more  recently , anti - tumor necrosis factor { NSAIDs } , and immune  checkpoint inhibitors targeting programmed cell death  receptor 1 and its ligand . 

2. VACCINES 
BP has been associated with the administration  of various vaccines , such as influenza , swine flu, tetanus toxoid , and herpes zoster virus , although some author do not support this association . A administration of vaccinations might activate the immune system , but the  pathogenesis through which  vaccines may provoke BP  remain  unknown. Relationship between vaccination  and BP onset is complicated to demonstrate , considering the large use of vaccines  and the frequent  absences  of BP relapse after additional vaccination . 

3. INFECTION 
There are different ways for pathogen agents to induce an autoimmune disease . A  virus could affect b and T cells stimulating them respectively  to autoAbs productin , and Th1 to Th2 switch .  A  pathogen can  induce  cross - reactive autoAbs sharing epitopes with host cells . Parasitic  disease such as Sarcoptes  scabies infection , may trigger BP as a Koebner  phenomena , but it is very  important to differentiate  it from a bullous subtype of scabies that could  minic  BP.

4. PHYSICAL FACTORS 
Triggering or exacerbation of BP  has been reported after exposure  to a variety of physical factors . Despite  the frequent clinical and empirical  observation  of this  relationship. 

5. NUTRITION 
No dietary  triggers have been suspected of being  involved  in the   induction  of the BP . One case  of DIF  positive dyshidrosiform pemphigoid  induced by nickel in the diet has been reported , completely resolved after a nickel - free diet . 

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