Murrell et al reported criteria for treatment failure in a patient with bullous pemphigoid. The authors are from multiple sites from around the world.
Patient selection: bullous pemphigoid
Criteria for therapeutic failure for initial control:
(1) one or more of the following:
(1a) development of new, nontransient lesions
(1b) continued extension of old lesions
(1c) failure of established lesions to heal
(1d) daily pruritus
(2) despite adequate therapy with corticosteroids with or without higher doses of adjuvants for >= 21 days (at least 3 weeks),IF(B
Adequate steroid therapy:
(1) prednisone: 0.75 mg per kg per day for >= 3 weeks
(2) topical clobetasol propionate at 40 g/h for 4 weeks
Adjuvants:
(1) dapsone
(2) tetracycline
(3) methotrexate
(4) azathioprine
(5) mycophenolate mofetil
