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Penfigoide bolhoso

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Last reviewed: 20 Aug 2025
Last updated: 11 Dec 2020

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • prurido
  • vesículas tensas em uma pele normal ou eritematosa
Full details

Other diagnostic factors

  • placas eritematosas ou urticariformes
  • lesões orais
Full details

Risk factors

  • idade entre 60 e 90 anos
  • alelo de classe II do complexo principal de histocompatibilidade (CPH) (DQB1*0301)
  • sexo masculino
Full details

Diagnostic tests

1st tests to order

  • biópsia da pele para avaliação histopatológica com microscopia óptica
  • biópsia de pele para teste de imunofluorescência direta
  • teste da imunofluorescência indireta no soro
Full details

Tests to consider

  • teste ensaio de imunoadsorção enzimática (ELISA)
Full details

Emerging tests

  • immunoblotting
  • imunoprecipitação
  • técnica de mapeamento de antígeno por sobreposição de fluorescência (FOAM)

Treatment algorithm

ACUTE

lesões localizadas em crianças ou adultos

lesões disseminadas em adultos

lesões disseminadas em crianças

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.

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.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Cotell S, Robinson ND, Chan LS. Autoimmune blistering skin diseases. Am J Emerg Med. 2000;18:288-299. Abstract

Kirtschig G, Middleton P, Bennett C, et al. Interventions for bullous pemphigoid. Cochrane Database Syst Rev. 2010;(10):CD002292.Full text  Abstract

Kirtschig G, Khumalo NP. Management of bullous pemphigoid: recommendations for immunomodulatory treatments. Am J Clin Dermatol. 2004;5:319-26. Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Penfigoide bolhoso images

  • Differentials

    • Pênfigo vulgar
    • Epidermólise bolhosa adquirida
    • Dermatose de imunoglobulina A (IgA) linear
    More Differentials

  • Guidelines

    • Consensus on the treatment of autoimmune bullous dermatoses: bullous pemphigoid, mucous membrane pemphigoid and epidermolysis bullosa acquisita
    • Japanese guidelines for the management of pemphigoid (including epidermolysis bullosa acquisita)
    More Guidelines

  • Calculators

    Escore de capacidade funcional de Karnofsky

    More Calculators
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