Treatment of generalized bullous pemphigoid with oral tetracycline.

Abstract

Although bullous pemphigoid (BP) is a benign self-limited disease, the mainstay of treatment remains systemic steroids, often in combination with immunosuppressive agents. This therapy has considerable potential toxicity, particularly in elderly patients with preexisting problems. The purpose of this study was to evaluate the efficacy of oral tetracycline as first-choice therapy in patients with BP. Every patient newly diagnosed with generalized BP was treated with oral tetracycline and a midpotency topical steroid. In all five patients, blister formation was stopped and reepithelialization completed within 1 to 3 weeks. There was no relapse or toxicity noted; follow-up ranged from 16 to 24 months. Oral tetracycline was found to be rapidly efficacious in all patients and devoid of toxicity.