Bullous Diseases

Autoimmune bullous diseases are a heterogeneous group of blistering diseases affecting the skin and/or mucous membrane. Systemic corticosteroids, which are often associated with immunosuppressants, are the main treatment option for these diseases. The 2 main biologics used in the treatment of autoimmune bullous diseases are rituximab, especially in pemphigus and mucous membrane pemphigoid, and omalizumab in bullous pemphigoid. Rituximab is a promising therapeutic option in pemphigus and mucous membrane pemphigoid. Its tolerance is rather good, although rare but potentially severe side effects can occur. Omalizumab has not been robustly evaluated in the treatment of bullous pemphigoid. Some case reports suggest that this drug might be of interest in a few patients with recalcitrant BP and high immunoglobulin E serum levels. Interestingly, this drug is generally well tolerated.