Jim Flaherty’s Skin Woe
His marked weight gain and puffy face had been fuelling rumours on Parliament Hill for months. Today, Jim Flaherty, our Minister of Finance, announced publicly that he is undergoing treatment for a non-life-threatening skin disease known as bullous pemphigoid. We asked our go-to derm Dr. Lisa Kellett for The Skiny on this rare condition.
Bullous pemphigoid (BP) is a blistering skin disease of the skin. It is usually seen in older adults but can rarely affect children. The cause of BP is often an autoimmune problem however in some cases other diseases and medications can cause it. The most likely cause, an autoimmune response means that antibodies are produced by the patient’s own body against certain parts of the skin. When these antibodies attack the skin they cause redness and blisters. The blisters are found typically on the arms, legs and trunk although they can appear anywhere. The blisters are usually filled with clear fluid.
In terms of symptoms, there may be no symptoms or irritation, itching and pain. While the skin is the most common site to be involved, in some cases the inside of the mouth can also be affected with sores. If this happens some patients have bleeding gums. Occasionally the eyes can also be involved. The symptoms usually come and go but it can be quite alarming and debilitating for the patient. While it is relatively rare, Dermatologists are well trained in the diagnosis and management of bullous pemphigoid and I have seen many patients with BP.
It is important to see a Dermatologist immediately as the diagnosis is usually confirmed with biopsies of the skin and special tests that can demonstrate what level of the skin the blistering is occurring. Often blood tests are also done. Untreated bullous pemphigoid can last months to many years. Treatment depends on the extensiveness of the disease but can range from topical steroid creams to oral steroids. There is a risk to taking oral steroids such as diabetes, osteoporosis, weight gain and suppression of the immune system. Other medications used to treat this disease include powerful immunosuppressive agents. In general, the disease usually responds to treatment although sometimes the disease recurs when treatment is stopped. Complications can sometimes occur either due to the disease with infection and in severe cases with blindness or breathing problems if it affects the eyes or respiratory system. In addition, there can be reactions to the strong medications used to treat the disease.