Bullous Pemphigoid (cont.)

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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 terribly affect daily lives in its more severe forms. Mild bullous pemphigoid can resolve with topical cortisone creams but sometimes requires high doses of cortisone ("steroids") taken internally. Severe bullous pemphigoid can also require immune-suppression drugs such as azathioprine (Imuran), mycophenolate (Cellcept), and methotrexate (Rheumatrex). Tetracycline has 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 entire body surface were safer and more effective in controlling extensive 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.

REFERENCE:

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 2/11/2013

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