Bullous pemphigoid (BP) is often pruritic. Patients are usually over 60 years of age and present with tense bullae on normal skin (Fig. 26-1) or on an urticarial lesion. The bullae are subepidermal and eventually break, leaving an erosion. Healing occurs with temporary dyspigmentation, but without scarring. Mucous membranes are rarely affected in BP. However, a variant known as benign mucous membrane pemphigoid (cicatricial pemphigoid) affects the mucosal surfaces primarily, the mouth and eyes most often, and can result in blindness. BP may be caused by thiazide diuretics, spironolactone, furosemide, captopril, penicillamine, phenothiazines, tricyclic antidepressants, or benzodiazepines. BP is not a marker for internal malignancy as previously believed.