Tetracycline and nicotinamide for the treatment of bullous pemphigoid: our experience in Singapore.
OBJECTIVE
To study the efficacy of tetracycline (or doxycycline) and nicotinamide in the treatment of less extensive bullous pemphigoid.


METHODS
An open trial of 11 patients with bullous pemphigoid. Treatment was initiated with tetracycline 1.5-2 g/day and nicotinamide 1.5-2 g/day and gradually tapered down. Doxycycline was substituted for tetracycline in patients who could not tolerate tetracycline due to gastrointestinal side effects or headache.


RESULTS
6 out of 11 patients achieved complete response (> 90% decrease in lesions) while another 2 had partial response (50-90% decrease in lesions).


CONCLUSIONS
Tetracycline/doxycycline and nicotinamide is a useful alternative treatment for localized bullous pemphigoid, especially in those whose concurrent medical illnesses preclude the use of systemic corticosteroids.
Goon
A T
AT
National Skin Centre, Singapore.
Tan
S H
SH
Khoo
L S
LS
Tan
T
T
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D003176:Complement C3 / Q000032:analysis; D003967:Diarrhea / Q000139:chemically induced; D004318:Doxycycline / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D006261:Headache / Q000139:chemically induced; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D009536:Niacinamide / Q000008:administration & dosage / Q000627:therapeutic use*; D010391:Pemphigoid, Bullous / Q000175:diagnosis / Q000188:drug therapy*; D012008:Recurrence; D012074:Remission Induction; D012867:Skin / Q000473:pathology; D013752:Tetracycline / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D014839:Vomiting / Q000139:chemically induced
D000900:Anti-Bacterial Agents; D003176:Complement C3; D004338:Drug Combinations; D007074:Immunoglobulin G; D009536:Niacinamide; D013752:Tetracycline; D004318:Doxycycline