Potent topical and/or systemic corticosteroids are first-line treatment of bullous pemphigoid

Bullous pemphigoid is an autoimmune blistering disease occurring mainly in the elderly. Although the condition is persistent and adversely affects patients' health-related quality of life, remission eventually occurs within about 5 years. Treatment with oral corticosteroids is often effective, but may be poorly tolerated. The potent topical corticosteroid clobetasol propionate has similar efficacy to oral corticosteroids and is associated with less severe adverse events. When oral corticosteroids are used, the dosage should be kept as low as possible. For patients who fail to respond to corticosteroid therapy, adjunctive or alternative treatments include antibacterials, immunosuppressants, plasmapheresis and immunoglobulin. There is insufficient data from controlled studies to determine the effectiveness of most of these approaches. © 2006 Adis Data Information BV. All rights reserved.