Disorders of various types that cause eruptions of blisters
- Some types are due to an abnormal gene inherited from both parents
- Age as a risk factor depends on the type
- Gender and lifestyle are not significant factors
There are several uncommon diseases that produce eruptions of blistering on the surface of the skin. These blistering diseases may either occur in particular sites or cover widespread areas of the body. In contrast to individual blisters, which are minor skin injuries, blistering diseases can be serious. Left untreated, these diseases may eventually become life-threatening.
What are the types?
Some rare types of blistering disease are present at birth and are caused by an abnormal gene inherited from both parents in an autosomal recessive manner (see Gene disorders). These diseases cause the skin over the whole body to become very fragile and blister when rubbed. They may be fatal.
More commonly, blistering diseases are acquired in adulthood. The three main types are autoimmune disorders, in which the body produces antibodies that are damaging to the skin.
The most common type of blistering disease is pemphigoid. The disorder affects people over the age of 60. It results in numerous tightly filled blisters, mainly on the legs and trunk, each measuring up to 3 cm (1
Less common than pemphigoid, pemphigus also usually affects people over the age of 60. In this condition, blisters may appear on any part of the body but often occur around the eyes, inside the mouth, and on the scalp. The blisters are fragile and may rupture spontaneously, leaving patches of raw skin.
This disorder is associated with an allergy to gluten, the protein in wheat (see Coeliac disease). The condition results in itchy blisters, usually on the elbows, buttocks, and knees.
What might be done?
In all types of blistering disease, diagnosis is usually based on a skin biopsy. This procedure involves taking a sample of skin for examination.
There is no effective treatment for inherited blistering diseases. Parents of babies who have these diseases may wish to seek genetic counselling to discuss the likelihood of further children also being affected.
If you have either pemphigoid or pemphigus, your doctor will prescribe oral corticosteroids. Some people will also need immunosuppressants for several weeks or months. If you have severe pemphigus, you may need immediate treatment in hospital with immunosuppressants.
In most cases, dermatitis herpetiformis disappears once the affected person has adopted a gluten-free diet, but the drug dapsone may also be needed to help clear up the blisters.
What is the prognosis?
The blistering diseases that affect adults can often be controlled with treatment, but very few cases can be permanently cured. Although pemphigoid may disappear spontaneously in 2–5 years, pemphigus often needs lifelong treatment with drugs. The allergic condition dermatitis herpetiformis may recur if gluten is reintroduced into the diet.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
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