Eosinophils in bullous pemphigoid: a narrative review
DOI:
https://doi.org/10.29176/2590843X.1998Keywords:
vesiculobullous skin diseases, Bullous pemphigoid, eosinophils, immunoglobulin E, pathophysiologyAbstract
Bullous Pemphigoid (BP) is an uncommon autoimmune blistering disease primarily affecting the elderly, with an incidence ranging from 2.4 to 42.8 cases per million person-years. In Colombia, it ranks among the most frequent autoimmune blistering diseases, predominantly affecting women over 70 years old. BP typically presents as tense blisters on erythematous or urticarial plaques, mainly on the trunk and flexural areas, and may involve mucous membranes in 10-30% of cases. Diagnosis is based on clinical features and paraclinical tests such as histopathology and immunofluorescence. Higher severity and mortality have been associated with elevated eosinophil counts in tissues.
Eosinophils, normally present in low levels, can increase in allergic and infectious diseases. In BP, eosinophils play a crucial role in blister formation through degranulation, which degrades the basement membrane. BP pathogenesis involves autoantibodies against hemidesmosome components like BP180 and complement activation, which recruits eosinophils. IgE also plays a significant role in eosinophil activation.
Standard treatment includes glucocorticoids and sometimes immunosuppressive therapies. Biological options such as rituximab, omalizumab, and dupilumab have shown benefits, particularly in refractory cases. New therapies targeting eosinophils and their pathways are under study, showing promising preliminary results. Understanding the role of eosinophils in BP is leading to the development of more specific and effective treatments.
Author Biographies
Artur Moraes-L'Abbate, Pontificia Universidad Javeriana, Bogotá, Colombia
Residente de Dermatología, Pontificia Universidad Javeriana, Bogotá, Colombia
Carolina Cortés Correa, Hospital Universitario de la Samaritana, Bogotá, Colombia
Dermatóloga, Hospital Universitario de la Samaritana, Bogotá, Colombia.
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Copyright (c) 2025 Artur Moraes-L'Abbate, Carolina Cortés Correa
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