Bullous autoimmune diseases can be either intraepidermal (pemphigus category of disorders) or subepidermal autoimmune bullous diseases (pemphigoid group of disorders). The introduction of systemic corticosteroids greatly decreased pemphigus-related mortality. 

Corticosteroids with adjuvants such as azathioprine and mycophenolate mofetil continue to be the primary treatment for these disorders. However, the deleterious effects associated with continuous use of these medications areconcerning. 

The US Food and Drug Administration (USFDA) defines biologics as therapeutic treatments generated from any living organism (microbes, plants, animals, and humans). In the recent decade, rituximab, a chimeric monoclonal antibody directed against B cells expressing the membrane-embedded surface protein CD20, has emerged as an attractive alternative for the treatment of resistant pemphigus vulgaris. 

Numerous novel biologics have since been introduced for the treatment of various autoimmune bullous dermatoses. These have the potential to be more effective while having fewer side effects than standard immunosuppressive agents. 

The present review addresses the function of several biologics in the treatment of autoimmune bullous disorders, followed by a discussion of the advantages and disadvantages of their use, as well as recent discoveries in this field.

Source: Indian Journal of Dermatology, Venereology and Leprology. Sep-Oct 2021;87(5):611-620. doi: 10.25259/IJDVL_886_19.