title: "Half-half" blisters in bullous pemphigoid successfully treated with adjuvant high-dose intravenous immunoglobulin.
abstract: Bullous pemphigoid is a rare, autoimmune blistering disease. Its clinical presentation is tense blisters that may arise on normal-appearing or erythematous skin. Bullous pemphigoid refractory to systemic corticosteroids in combination with immunosuppressants such as azathioprine and mycophenolate mofetil may benefit from adjuvant high-dose intravenous immunoglobulin (IVIg). We describe a particular case with an unusual clinical presentation unresponsive to systemic corticosteroids plus azathioprine, in which the addition of high-dose IVIg was successful. The combined therapy of systemic corticosteroids and azathioprine plus high-dose IVIg can be an option in refractory cases due to its efficiency and tolerability.
authors.affiliation: Serviço de Dermatologia, Hospital de Santa Maria-Centro Hospitalar Lisboa Norte Avenida Prof. Egas Moniz, Lisbon, Portugal. pachecocas@hotmail.com
authors.forename: David
authors.initials: D
authors.lastname: Pacheco
authors.forename: Leonor
authors.initials: L
authors.lastname: Lopes
authors.forename: Luis
authors.initials: L
authors.lastname: Soares-Almeida
authors.forename: Manuel Sacramento
authors.initials: MS
authors.lastname: Marques
authors.forename: Paulo
authors.initials: P
authors.lastname: Filipe
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use; D001768:Blister / Q000188:drug therapy* / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000188:drug therapy* / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors; D001379:Azathioprine; D011241:Prednisone