Blistering Diseases in the Mature Patient

Publication date: Available online 3 October 2017
Source:Clinics in Dermatology
Author(s): Ines Lakoš Jukić, Sandra Jerković Gulin, Branka Marinović
Autoimmune blistering diseases (AIBD) are a group of chronic diseases affecting the skin and mucous membranes, with different presentation, clinical course, histologic and immunopathologic findings and different therapeutic approach. Blisters develop as a result of autoantibodies directed against distinct adhesion structures within desmosomes or within basement membrane zone, Most common autoimmune blistering disease that develop in elderly is bullous pemphigoid (previously also named pemphigoid senilis), but mature patients can also present with other AIBDs as mucous membrane pemphigoid, epidermolysis bullosa aquisita, paraneoplastic pemphigus, pemphigus vulgaris, pemphigus foliaceus, linear IgA dermatosis, and dermatitis herpetiformis. There are no differences in treatment approach to mature patients with AIBD, but due to more common comorbidities systemic therapy should be given with more caution and control and due to distorted skin integrity in the aged skin, the safety concerns are increased with the long-term use of any topical medication.