How is bullous pemphigoid disease activity classified?

Mild BP: =10 blisters/24h. Severe: >=10 blisters/24h with positive Nikolsky sign or mucosal involvement. IgG anti-BP180 and anti-BP230 levels correlate with disease activity.

What is the first-line treatment for moderate-severe BP?

Super-potent topical corticosteroids (clobetasol propionate 40g/day) are recommended for moderate-to-severe BP per Cochrane review - superior to oral prednisolone with fewer systemic side effects. Doxycycline + nicotinamide for mild BP.

What targeted therapies are available for BP?

Dupilumab (anti-IL-4R) and nemolizumab (anti-IL-31RA) have shown efficacy in recalcitrant BP. Omalizumab (anti-IgE) is used off-label. Clinical trials of anti-IL-17 and anti-complement therapies are ongoing.

Bullous Pemphigoid BPDAI Scoring

Calculate BPDAI (Bullous Pemphigoid Disease Area Index): skin blistering activity (0-120), urticaria/erythema activity (0-120), and mucous membrane activity (0-120) to guide treatment decisions.

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PDAI Pemphigus Score

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Bullous Pemphigoid BPDAI Scoring

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Frequently Asked Questions

How is bullous pemphigoid disease activity classified?

What is the first-line treatment for moderate-severe BP?

What targeted therapies are available for BP?