Can What You Eat Trigger Bullous Pemphigoid, a Rare Skin Condition?

Bullous Pemphigoid (BP) is an autoimmune disease where the body produces antibodies that attack the skin, starting an inflammatory reaction, then causing blisters and lesions on the outer layer of the skin.

The common environmental factors known for triggering BP flares are:

Infections;

Certain medications;
UV light.

In reviewing evidence of food-related triggers, there are foods and additives in foods that may trigger BP:

Nickel, which may be present in a surprisingly large number of food products including black tea, nuts, and seeds, and some canned or processed foods, among many others;
Milk;
Iodine, which can be found in some meat and fish, iodized salt, and some dairy and eggs;
Tomato;
Gluten.

Vitamin D is an immunomodulator (works directly on the immune system) that regulates T cells. This means it plays a role in helping the body defend itself against infection. People with BP have been found to have lower than normal levels of vitamin D.

Can Nutritional Supplementation Help?

There is no conclusive evidence to show that adding Vitamin D can help protect you against a flare of BP -- but you may want to ask your doctor what's right for you. However, there have been a number of studies on the effects of nicotinamide supplementation on BP patients. Nicotinamide supplements – a vitamin B3 or niacin– in combination with an anti-inflammatory antibiotic, like tetracycline, have been shown to be an effective treatment for BP. Nevertheless, there is only one study that compared this treatment to the standard of care, oral prednisone. In that study, nicotinamide supplements had the same effectiveness as oral prednisone, but with fewer side effects – especially those associated with steroid use. You can speak with your doctor about nutritional supplementation to find out what's right for you.

Source:

V. Stoj and J. Lu, Nutrition and Bullous Diseases, Clinics in Dermatology, https://doi.org/10.1016/j.clindermatol.2021.10.009