Bullous Pemphigoid

  • Medical Author:
    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

  • Medical Editor: Melissa Conrad Stöppler, MD
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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What is the treatment for bullous pemphigoid?

Bullous pemphigoid can be chronic and mild without substantially disturbing the general health of affected individuals. It can also significantly affect daily lives in its more severe forms. Mild bullous pemphigoid can resolve with topical prescription corticosteroid creams but sometimes requires high doses of steroids taken internally. Severe bullous pemphigoid can also require immune-suppression drugs such as azathioprine (Imuran), mycophenolate (Cellcept), and methotrexate (Rheumatrex). The tetracycline derivatives such as minocycline or doxycycline have also been used as an option to reduce inflammation. Other treatments that have been used for severe disease include intravenous immunoglobulin infusions, typically given monthly.

Research has indicated that large quantities of high-potency topical corticosteroids applied to the body surface are safer in controlling localized bullous pemphigoid than oral corticosteroids. It was felt by the researchers that topical corticosteroids should now be the treatment of choice for bullous pemphigoid, particularly when the disease is not extensive.

What is the prognosis of bullous pemphigoid?

The outlook for bullous pemphigoid is variable. As described above, the symptoms tend to wax and wane. In its most severe form it can be fatal without treatment, especially if involving the airways and pharynx.

Medically reciewed by Norman Levine, MD; American Board of Dermatology


Leiferman, Kristin M., et al. "Epidemiology and pathogenesis of bullous pemphigoid and mucous membrane pemphigoid." UpToDate. 12 Dec. 2012.

Medically Reviewed by a Doctor on 4/15/2015

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