Treatment of autoimmune blistering diseases

The treatment of autoimmune blistering diseases remains therapeutically challenging. Significant improvement in the management of autoimmune bullous diseases has occurred as a consequence of improvements in our ability to predict, monitor, and treat the deleterious effects associated with the drugs used to treat these conditions and the introduction of new agents with lower toxicity. Examples include improvements in monitoring and preventing osteoporosis in patients on long-term systemic corticosteroids, the detection of those at risk for azathioprine toxicity bowing to low thiopurine methyltransferase activity, and the addition of agents such as mycophenolate mofetil and IVIG to our therapeutic armamentarium. These advances offer the promise of improved disease control with fewer side-effects and long-term toxicity for our patients.