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Related Experiment Video

Updated: Jan 27, 2026

Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
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[Management of bullous pemphigoid].

M Göbel1, R Eming2

  • 1Klinik für Dermatologie und Allergologie, Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Baldingerstr., 35043, Marburg, Deutschland. manuel.goebel@med.uni-marburg.de.

Der Hautarzt; Zeitschrift Fur Dermatologie, Venerologie, Und Verwandte Gebiete
|March 16, 2019
PubMed
Summary

Bullous pemphigoid is an autoimmune skin blistering disease in adults over 70. Treatment involves topical corticosteroids, immunosuppressives, or newer therapies for severe or refractory cases.

Keywords:
AutoantibodyAutoimmune diseasesCorticosteroidsGlucocorticoidsImmunosuppressants

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Area of Science:

  • Dermatology
  • Immunology
  • Autoimmune Diseases

Background:

  • Bullous pemphigoid is the most common autoimmune blistering skin disease in adults.
  • It results from autoantibodies targeting hemidesmosomal proteins, causing subepidermal blistering.
  • Patients, typically over 70, present with skin bullae and erosions, occasionally affecting mucous membranes.

Purpose of the Study:

  • To address the need for effective long-term treatments for bullous pemphigoid, considering side effects and comorbidities.
  • To explore treatment options for the chronically relapsing nature of the disease.
  • To highlight the absence of a definitive curative treatment.

Main Methods:

  • Treatment selection is guided by disease activity and mucocutaneous manifestation extent.
  • High-potency topical corticosteroids are preferred for fewer side effects.
  • Systemic corticosteroids are combined with immunomodulators or immunosuppressives for severe or refractory cases.

Main Results:

  • Topical class IV corticosteroids are effective for milder cases.
  • Systemic corticosteroids combined with agents like dapsone, doxycycline, azathioprine, mycophenolate, or methotrexate manage intense or refractory disease.
  • Off-label options like rituximab and IVIg are available for refractory cases.

Conclusions:

  • Treatment strategies should be tailored to individual patient needs and disease severity.
  • Long-term use of immunosuppressants is recommended to minimize corticosteroid dependency.
  • Current treatments aim to manage symptoms and prevent relapse, as no cure exists.