Vesiculobullous Diseases

Question 1

Bullous Pemphigoid

best initial therapy is

Answer 1

prednisone.
To get patients off steroids, use azathioprine,
cyclophosphamide, or mycophenolate.

Question 2

Mild bullous pemphigoid responds to______

Answer 2

erythromycin, dapsone, and

nicotinamide (not niacin)

Question 3

Pemphigus Vulgaris

Answer 3

• Systemic steroids (prednisone)
• Azathioprine or mycophenolate to wean the patient off steroids
• Rituximab (anti-CD20 antibodies) or IVIG in refractory cases

Question 4

Dermatitis Herpetiformis

Answer 4

• dapsone (sulfapyridine if contraindicated or poorly tolerated)
• gluten-free diet for life – this can reduce risk of lymphoma

Question 5

Porphyria Cutanea Tarda

Answer 5

• discontinue aggravating substances (alcohol, estrogen therapy)
• phlebotomy to decrease body iron load
• low dose hydroxychloroquine