What is the Difference Between Bullous Pemphigoid and Pemphigus Vulgaris

The key difference between bullous pemphigoid and pemphigus vulgaris is that bullous pemphigoid is an autoimmune skin condition caused due to autoantibodies against hemidesmosomes, while pemphigus vulgaris is an autoimmune skin condition caused due to autoantibodies against desmoglein.

Autoimmune disease is a disorder in which the human body attacks itself. In this case, the antibodies attack healthy tissues instead of harmful ones. This causes many different symptoms and harmful effects on the joints, internal organs, and the skin. Bullous pemphigoid and pemphigus vulgaris are two different types of autoimmune skin diseases.

1. Overview and Key Difference
2. What is Bullous Pemphigoid
3. What is Pemphigus Vulgaris
4. Similarities – Bullous Pemphigoid and Pemphigus Vulgaris
5. Bullous Pemphigoid vs Pemphigus Vulgaris in Tabular Form
6. Summary – Bullous Pemphigoid vs Pemphigus Vulgaris

What is Bullous Pemphigoid?

Bullous pemphigoid is an autoimmune skin condition that is caused due to autoantibodies against hemidesmosomes. The hemidesmosomes are multiprotein complexes that help the stable adhesion of basal epithelial cells to the underlying basement membrane. It is a rare skin disorder mainly affecting older people. Bullous pemphigoid normally starts as an itchy, raised rash on the skin. As it develops, it turns into large blisters formed on the skin. This condition may last a few years and sometimes can cause serious problems.

Bullous Pemphigoid vs Pemphigus Vulgaris in Tabular Form

Figure 01: Bullous Pemphigoid

Bullous pemphigoid is not contagious, caused by an allergy, or affected by diet or lifestyle. Sometimes it has been linked to skin damage by sunburn or taking certain medicines. The signs and symptoms may include itching skin weeks or months before blisters occur, large blisters that don’t easily rupture when touched, normal skin around the blisters, reddish or darker than normal, eczema, and small blisters or sores in the mouth or other mucous membranes.

Bullous pemphigoid can be diagnosed through physical examinations, blood tests, or skin biopsy. Furthermore, treatments for bullous pemphigoid may include medicines like corticosteroids, steroids-sparing drugs (azathioprine), and other drugs that fight inflammation (methotrexate).

What is Pemphigus Vulgaris?

Pemphigus Vulgaris is an autoimmune skin condition that is caused due to autoantibodies against desmoglein. Desmoglein is a cadherin-like adhesion molecule that helps to maintain tissue integrity. These proteins also facilitate cell-to-cell communication. It is a rare autoimmune disease. Pemphigus Vulgaris commonly affects people aged bet 30 to 60 years.

Bullous Pemphigoid and Pemphigus Vulgaris - Side by Side Comparison

Figure 02: Pemphigus Vulgaris

It causes blisters on the skin and mucous membranes throughout the body. Pemphigus Vulgaris can affect the mouth, nose, throat, eyes, and genitals. The blisters normally are painful but do not itch. Moreover, blisters in the mouth or throat may make it hard to swallow and eat. This condition is most commonly identified in Jews and Indians than in other races, presumably due to genetic reasons. Pemphigus Vulgaris can be diagnosed through physical examination, skin biopsy, blood test, and endoscopy. Furthermore, the treatments for pemphigus vulgaris include medicines like corticosteroids, steroid-sparing immunosuppressant drugs (azathioprine, mycophenolate, and cyclophosphamide), and other medications like dapsone, intravenous immunoglobulins, or rituximab.

What are the Similarities Between Pemphigoid and Pemphigus Vulgaris?

Bullous pemphigoid and pemphigus vulgaris are two different types of autoimmune skin diseases.
Both are rare skin conditions.
In both conditions, blisters on the skin can be identified.
Both skin disorders can be diagnosed through physical examination.
They can be treated through medications like corticosteroids.

What is the Difference Between Bullous Pemphigoid and Pemphigus Vulgaris?

Bullous pemphigoid is an autoimmune skin condition that is caused due to autoantibodies against hemidesmosomes, while pemphigus vulgaris is an autoimmune skin condition that is caused due to autoantibodies against desmoglein. Thus, this is the key difference between bullous pemphigoid and pemphigus vulgaris. Furthermore, bullous pemphigoid can be commonly identified in people over 50 to 80 years of age. On the other hand, pemphigus vulgaris is commonly identified in people over 30 to 60 years of age.

The below infographic presents the differences between bullous pemphigoid and pemphigus vulgaris in tabular form for side-by-side comparison.

Summary – Bullous Pemphigoid vs Pemphigus Vulgaris

Bullous pemphigoid and pemphigus vulgaris are two rare autoimmune skin diseases. Bullous pemphigoid occurs due to autoantibodies against hemidesmosomes, while pemphigus vulgaris occurs due to autoantibodies against desmoglein. In both conditions, blisters can be seen on the skin. So, this summarizes the difference between bullous pemphigoid and pemphigus vulgaris.

Reference:

1. “Bullous Pemphigoid.” DermNet.
2. “Pemphigus Vulgaris.” Johns Hopkins Medicine.

Image Courtesy:

1. “Bullous pemphigoid new image” By Mohammad2018 – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Pemphgoid vulgaris” By Mohammad2018 – Own work (CC BY-SA 4.0) via Commons Wikimedia