[Bullous pemphigoid treated by plasma exchange. Open study in 10 patients]

Ten patients with bullous pemphigoid underwent low volume plasma exchange (1/3 to 1/2 of the plasmatic mass) 3 times a week for 2 to 6 weeks followed, in some of them, by maintenance corticosteroid therapy. Eight patients benefited from this treatment. Complete control of the disease was obtained with PE alone in 3: low-dose corticosteroids were sufficient to procure remission in 2, and dosage could be reduced in 3 patients who previously required high doses of corticosteroids. No serious side-effects were recorded. The best results were observed in patients who had been ill for less than 3 months. Thus, low volume plasma exchanges make it possible to obtain clinical improvement while avoiding the rebound phenomena sometimes observed after high volume plasma exchanges. Circulating immune complexes and pemphigoid antibodies usually decreased under treatment, but there was no close correlation between these changes and therapeutic effectiveness.