Practice and Educational Gaps in Blistering Disease

Treatment of autoimmune patients can be challenging and rewarding. These patients often remain undiagnosed for prolonged periods of time or underdiagnosed without immunologic confirmation, resulting in significant morbidity. The most important principle in management of autoimmune bullous disease is to halt blistering activity while minimizing side effects of medications, especially those caused by corticosteroids. Judicious use of systemic steroids and steroid-sparing agents are essential tools in the management of these patients. Rituximab and intravenous immunoglobulin are playing increasingly important and earlier roles in management. Understanding of and surveillance for drug side effects are critical in long-term management.