Q: My husband has blisters on his skin. The blisters begin with swelling, then small white blisters appear and sometimes there is pus too. He has been hospitalised twice for this problem. His dermatologist has taken several biopsies but has not arrived at any diagnosis. Each time the blisters appear we give him a high dose of prednisolone. His eosinophils level has been 30%. We are told that the normal range is under 5%. We have not been given an answer as to what is causing this. Can you tell us how to find out any information about his problem?

A:He is likely to be suffering from autoimmune blistering disorder. Most likely, it may be bullous pemphigoid (as there is blood eosinophilia, urticarial and tense bullous lesions on the skin). Skin biopsy for histopathology and direct immuno-fluorescence are required to confirm diagnosis. Treatment with steroids (Prednisolone, or DCP), tetracycline/nicotinamide combination, dapsone or additional immunosuppressives may be required. Consult a good dermatologist for proper management, as treatment may be required for years together.