Erythromycin therapy in bullous pemphigoid: possible anti-inflammatory effects

Two patients with bullous pemphigoid treated with erythromycin demonstrated improvement. This response suggests that erythromycin may be a fairly safe supplemental drug which may allow a lower dose of systemic steroid, or may be of benefit when used alone or in combination with topical steroids in treating patients who are not ideal candidates for a systemic steroid. Erythromycin appears to have a significant anti-inflammatory effect, and possible mechanisms for this effect are proposed. One of the patients was a 4 1/2-year-old girl whose disease manifested several unusual features, making diagnosis difficult. A brief summary of differential immunofluorescent findings in childhood bullous diseases is also presented.