Basic pharmacologic approach to immunosuppressive therapy for autoimmune blistering diseases

The pathophysiology of the most important bullous skin diseases, pemphigus and bullous pemphigoid, has been carefully defined by the use of experimental animal models of the diseases. This has shown that to successfully treat pemphigus, one must reduce autoantibody production, while in contrast, bullous pemphigoid can be treated by blocking any of several steps in an inflammatory cascade. This knowledge has led to rational therapeutic approaches to both disorders. This approach can be applied to other autoimmune bullous skin diseases, with an expected increase in efficacy of therapy and decreased morbidities from immunosuppressive drugs.