Last reviewed: 30 Sep 2024
Last updated: 11 Dec 2020
Summary
Definition
History and exam
Key diagnostic factors
- pruritus
- tense blisters on normal or erythematous skin
Full details
Other diagnostic factors
- erythematous or urticarial plaques
- oral lesions
Full details
Risk factors
- age 60 to 90 years
- major histocompatibility complex (MHC) class II allele (DQB1*0301)
- male sex
Full details
Diagnostic tests
1st tests to order
- skin biopsy for histopathologic evaluation with light microscopy
- skin biopsy for direct immunofluorescence testing
- indirect immunofluorescence test on serum
Full details
Tests to consider
- ELISA test
Full details
Emerging tests
- immunoblotting
- immunoprecipitation
- fluorescence overlay antigen mapping (FOAM) technique
Treatment algorithm
ACUTE
localized lesions in children or adults
widespread lesions in adults
widespread lesions in children
Contributors
Authors
Vesna Petronic-Rosic, MD, MSc, MBA
Professor and Chair
Department of Dermatology
Georgetown University
MedStar Washington Hospital Center
Washington
DC
Disclosures
VPR declares that she has no competing interests.
Peer reviewers
Lawrence Parish, MD
Clinical Professor of Dermatology and Cutaneous Biology
Director
Jefferson Center for International Dermatology
Jefferson Medical College
Thomas Jefferson University
Philadelphia
PA
Disclosures
LP declares that he has no competing interests.
Timothy Patton, MD
Assistant Professor of Dermatology
Department of Dermatology
University of Pittsburgh
Pittsburgh
PA
Disclosures
TP declares that he has no competing interests.
Differentials
- Pemphigus vulgaris
- Epidermolysis bullosa acquisita
- Linear IgA dermatosis
More DifferentialsGuidelines
- Guidelines for the management of bullous pemphigoid
More GuidelinesCalculators
Karnofsky Performance Status Score
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