Local treatments and supportive care

Abstract

While the primary treatment of autoimmune blistering diseases (ABD) has been systemic therapy, it is important to be aware of the value of several nonsystemic treatments. Topical corticosteroids (both as monotherapy and adjuvant therapy), intra-lesional corticosteroids and corticosteroid elixirs can play an important role in treatment. In addition, non-steroidal treatments such as topical calcineurin inhibitors and non-steroidal elixirs have also been reported in treatment of ABD. Furthermore, it is important to be aware of exogenous factors contributing to ABD (including food and nutrition, iodine, poor oral hygiene and ultraviolet light). Treatment of ABD is not complete without consideration of infection control and vaccination guidelines. Systemic antihistamines are also helpful in controlling symptoms of pruritus. A variety of local treatment options have proven to be benefi- cial in mild as well as moderate and severe disease as an adjuvant. Patients should be constantly encouraged and reminded that these measures may help reduce the dosage and duration of their systemic treatments, and in some mild cases provide remission of the ABD.