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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.