Treatment Options 

There are a number of medications and therapies available to patients:

  • Corticosteroids (e.g., prednisone) are most often used to get the disease “under control”. It is not uncommon to use it in combination with other treatment options in order to reduce the dose of this medication.  If used for prolonged periods of time, the side effects can be severe.
  • Immunosuppessants such as azathioprine (Imuran), mycophenolate mofetil (CellCept ®), mycophenolic acid (Myfortic®), cyclophosphamide (Cyotxan ®), and cyclosporine (Neoral®) are also used.  These drugs help suppress the part of the immune system that triggers the production of auto-antibodies. While it takes time for these medications to work, they have proven to be successful with many patients.
  • Other therapies used include intravenous immunoglobulin (IVIG), plasmapheresis – a blood filtering technique that removes antibodies from the blood, and a select number of biologics such as rituximab, infliximab, and etanercept.
  • Other drugs that are used with varying degrees of success include dapsone, gold injections, methotrexate, tetracycline, minocycline, doxycycline and niacinamide.

To date, there is no single medication or combination of medications and therapies that will guarantee remission.  (Remission is defined as a state in which a patient has had no lesions while off all therapies for at least two months.)  What works for one person, might not work for another.  It is, therefore, important that patients become knowledgeable about their options and work with their dermatologist and other healthcare professionals to determine the most appropriate strategy.