小结
定义
病史和体格检查
关键诊断因素
- pruritus
- tense blisters on normal or erythematous skin
其他诊断因素
- erythematous or urticarial plaques
- oral lesions
危险因素
- age 60 to 90 years
- major histocompatibility complex (MHC) class II allele (DQB1*0301)
- male sex
诊断性检查
首要检查
- skin biopsy for histopathologic evaluation with light microscopy
- skin biopsy for direct immunofluorescence testing
- indirect immunofluorescence test on serum
需考虑的检查
- ELISA test
新兴检查
- immunoblotting
- immunoprecipitation
- fluorescence overlay antigen mapping (FOAM) technique
治疗流程
localized lesions in children or adults
widespread lesions in adults
widespread lesions in children
撰稿人
作者
Vesna Petronic-Rosic, MD, MSc, MBA
Professor and Chair
Department of Dermatology
Georgetown University
MedStar Washington Hospital Center
Washington
DC
利益声明
VPR declares that she has no competing interests.
同行评议者
Lawrence Parish, MD
Clinical Professor of Dermatology and Cutaneous Biology
Director
Jefferson Center for International Dermatology
Jefferson Medical College
Thomas Jefferson University
Philadelphia
PA
利益声明
LP declares that he has no competing interests.
Timothy Patton, MD
Assistant Professor of Dermatology
Department of Dermatology
University of Pittsburgh
Pittsburgh
PA
利益声明
TP declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
参考文献
关键文献
Cotell S, Robinson ND, Chan LS. Autoimmune blistering skin diseases. Am J Emerg Med. 2000;18:288-299. 摘要
Kirtschig G, Middleton P, Bennett C, et al. Interventions for bullous pemphigoid. Cochrane Database Syst Rev. 2010;(10):CD002292.全文 摘要
Kirtschig G, Khumalo NP. Management of bullous pemphigoid: recommendations for immunomodulatory treatments. Am J Clin Dermatol. 2004;5:319-26. 摘要
参考文献
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
鉴别诊断
- Pemphigus vulgaris
- Epidermolysis bullosa acquisita
- Linear IgA dermatosis
更多 鉴别诊断指南
- Guidelines for the management of bullous pemphigoid
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