Severe bullous pemphigoid responsive to pulsed intravenous dexamethasone and oral cyclophosphamide

British Association of Dermatologists’ guidelines for the management of bullous pemphigoid 2012

“…Three cases have been reported in which cyclophosphamide appeared to have a beneficial effect in otherwise refractory BP. [82][83][84] In the only case series detailing the effects of cyclophosphamide in BP, 10 patients were treated with systemic steroid in doses of 1-1AE9 mg kg )1 daily prednisone equivalent and with cyclophosphamide 100 mg daily. 85 Three patients, who had medical comorbidities, died; four others suffered significant adverse effects involving marrow toxicity and septicaemia.…”

Treatment of subepidermal immunobullous diseases

“…Although cyclophosphamide is often used to treat ocular cicatricial pemphigoid, several case reports have suggested that cyclophosphamide may also be useful in cases of severe or refractory BP when given in either oral daily (1–5 mg/kg/d) or pulse intravenous dosing. 40,41 No large or randomized trials have been performed using this medication.…”

Use of intravenous immunoglobulin therapy in autoimmune blistering diseases

“…These drugs may be used as a single agent or in combination with others. In instances where these drugs are not effective, intravenous corticosteroids, intravenous cyclophosphamide, or plasmapheresis has been used [121][122][123][124][125].…”