(1997; 132 pages) [French] [Spanish]
Bullous pemphigoid, which occurs in elderly patients, is generally less severe than pemphigus. Spontaneous remission can occur and not all patients require systemic treatment. It is characterized by the formation of tense, often blood-filled, blisters in the skin, which tend to heal spontaneously. The blisters usually develop in the axillary and inguinal folds, but large areas of the body surface may be involved. However, in contrast to pemphigus vulgaris, their rupture does not result in large denuded areas of skin.
Systemic corticosteroids are the mainstay of treatment, but they must be used at the lowest effective dosage. Treatment should be continued until the serum is clear of detectable antibody and then be withdrawn gradually. Dapsone is also effective. The dosage is the same as for dermatitis herpetiformis (see below).