Bullous pemphigoid treated with intravenous immunoglobulin

Bullous pemphigoid (BP) is a blistering autoimmune disease that primarily affects elderly patients who commonly present with comorbidities. Side effects from long-term treatment with conventional cytotoxic and immunosuppressive agents may increase morbidity and mortality in this patient population. We present a case of BP in a 78-year-old woman with an active pulmonary Mycobacterium avium-intracellulare complex (MAC) infection that precluded the use of systemic corticosteroids or other immunosuppressants. Our patient was successfully treated with intravenous immunoglobulin (IVIG) monotherapy, which may provide an alternative treatment option for BP patients who are unable to tolerate cytotoxic or immunosuppressive therapies.