Immunologic bullous diseases: Blisters without a precipitating event

Although the overall incidence of immunologic bullous diseases is comparati vely low, they are nonetheless potentially lethal dermatologic disorders th at occur most commonly in individuals age 55 and older. Thus familiarity wi th the signs, symptoms,and treatments will be valuable to the primary care physician. For bullous diseases in general, the challenge is to differentia te between those arising from immunologic rather than exogenous causes, suc h as drug-induced or drug-triggered pemphigus. Treatment goals include scre ening for associated malignancies, managing the lesions, and minimizing the morbidity and mortality associated with the disease. Collaboration with a dermatologist can aid in achieving these objectives.