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Management of Bullous Pemphigoid

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Dr Muralidhar Rajagopalan, Chennai    21 January 2019

  • Bullous pemphigoid: Localized/limited disease with mild activity.
  • First choice: Super potent topical corticosteroids; in mild disease, on whole body except the face. In localized disease, on lesions only.
  • Second choice: Oral corticosteroids (validated for prednisone); tetracycline + nicotinamide (nonvalidated); dapsone, sulfonamides (nonvalidated) and topical immunomodulation (e.g., tacrolimus) (nonvalidated).
  • Third choice: Gaining more acceptance higher up in the ladder now - Combination with and/or introduction of: Anti-CD20 or anti-IgE monoclonal antibody; intravenous immunoglobulins; immunoadsorption; plasma exchange and cyclophosphamide.

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