Bullous Pemphigoid

Diagnosis

To confirm the diagnosis, your doctor may ask for blood tests and take a small sample of the affected skin (a skin biopsy) for testing in the laboratory. Based on your symptoms and the test results, your doctor may refer you to a specialist who focuses on skin issues (a dermatologist) or eye conditions (an ophthalmologist).

Treatment

The primary goal of treatment is to promote skin healing, alleviate itching, and minimize any potential adverse effects caused by medications. Your healthcare provider may recommend a single drug or a combination of medications to achieve these objectives:

One or combination of these drugs may include:

• Corticosteroids: The primary treatment often prescribed is prednisone, available in pill form. However, prolonged usage can elevate the risk of developing conditions such as weakened bones, diabetes, high blood pressure, high cholesterol, and infections. An alternative option involves corticosteroid ointments, which can be applied topically to the affected skin and typically result in fewer side effects.
• Steroid-sparing immunomodulatory drug: These medications function by suppressing the immune system, leading to a reduction in the production of disease-fighting white blood cells in your body. Azathioprine and mycophenolate mofetil are common examples of such drugs. In cases where symptoms affect the eyes or upper digestive tract and other treatments have proven ineffective, the drug rituximab may be considered as an alternative approach.
• Other medications: Methotrexate, an anti-inflammatory medication may be prescribed. If one is unable to take corticosteroids or other immunomodulatory medications, oral tetracycline or doxycycline pills may be given. IVIG infusions may also be used for refractory cases of bullous pemphigoid.