Bullous Pemphigoid Publisher Pubmed

Summary: Blistering skin disease rising? Review links bullous pemphigoid to autoantibodies BP180/BP230—urges new biologics like rituximab for elderly. #AutoimmuneDisease #Dermatology

Akbarialiabad H^{1, 2} ; Schmidt E³ ; Patsatsi A⁴ ; Lim YL^{5, 6, 7} ; Mosam A⁸ ; Tasanen K^{9, 10} ; Yamagami J¹¹ ; Daneshpazhooh M¹² ; De D¹³ ; Cardones ARG¹⁴ ; Joly P¹⁵ ; Murrell DF^{1, 2, 16}
Source: Nature Reviews Disease Primers Published:2025

Abstract

Bullous pemphigoid is a chronic, subepidermal autoimmune blistering disease characterized by tense blisters on erythematous or normal skin that predominantly affects the older population. The disease arises from autoantibodies targeting hemidesmosomal proteins BP180 and BP230, which are crucial for dermal–epidermal adhesion. The incidence of bullous pemphigoid is increasing, attributed to an ageing population and improved diagnostic recognition. Genetic predisposition, environmental triggers and associations with other autoimmune disorders underline its multifactorial nature. Diagnosis involves clinical presentation, histopathology, direct immunofluorescence and serological tests. Treatment aims to reduce symptoms and prevent new blister formation, using corticosteroids, immunosuppressive agents and biologics such as rituximab and omalizumab. Despite therapeutic advancements, challenges persist in long-term management, especially in older patients with comorbidities. Ongoing research into molecular mechanisms and novel therapeutic targets and clinical trials are crucial for the development of safer and more effective treatments. © Springer Nature Limited 2025.