Treatment of generalized bullous pemphigoid with oral tetracycline

Background: 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. Objective: The purpose of this study was to evaluate the efficacy of oral tetracycline as firstchoice therapy in patients with BP. Methods: Every patient newly diagnosed with generalized BP was treated with oral tetracycline and a midpotency topical steroid. Results: 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. Conclusion: Oral tetracycline was found to be rapidly efficacious in all patients and devoid of toxicity.