Clinical features and practical diagnosis of bullous pemphigoid

Immunol Allergy Clin North Am. 2012 May;32(2):217-32, v. doi: 10.1016/j.iac.2012.04.002. Epub 2012 Apr 17.


Bullous pemphigoid (BP) represents the most common autoimmune subepidermal blistering disease. BP typically affects the elderly and is associated with significant morbidity. It has usually a chronic course with spontaneous exacerbations. The cutaneous manifestations of BP can be extremely protean. While diagnosis of BP in the bullous stage is straightforward, in the non-bullous stage or in atypical variants of BP signs and symptoms are frequently non-specific with eg, only itchy excoriated, eczematous, papular and/or urticarial lesions that may persist for several weeks or months. Diagnosis of BP critically relies on immunopathologic examinations including direct immunofluorescence microscopy and detection of serum autoantibodies by indirect immunofluorescence microscopy or BP180-ELISA.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Autoantibodies / immunology
  • Autoantigens / immunology*
  • Autoantigens / metabolism
  • Blister / immunology
  • Blister / pathology
  • Comorbidity
  • Diagnosis, Differential
  • Hemidesmosomes / immunology*
  • Hemidesmosomes / metabolism
  • Humans
  • Incidence
  • Non-Fibrillar Collagens / immunology*
  • Non-Fibrillar Collagens / metabolism
  • Pemphigoid, Bullous / diagnosis*
  • Pemphigoid, Bullous / epidemiology
  • Pemphigoid, Bullous / pathology


  • Autoantibodies
  • Autoantigens
  • Non-Fibrillar Collagens
  • collagen type XVII