Treatment of generalized bullous pemphigoid with erythromycin and nicotinamide

INTRODUCTION: Bullous pemphigoid (BP) is the most common autoimmune blister ing disease. During the last years steroid-sparing therapeutic regimens hav e been used in order to attenuate treatment side effects, Among them, eryth romycin has been reported as effective in isolated cases. METHODS: This paper describes five patients, all of them older adults, diag nosed with BP, and who were treated with a combination of erythromycin (500 mg three times daily) and nicotinamide (400 mg three times daily). RESULTS: The treatment was hepatotoxic in one patient, The other four patie nts were free of lesions eight weeks after the beginning of therapy, No adv erse side effects were detected in those patients, CONCLUSION: This combination appears to be very interesting alternative to systemic corticosteroids due to its effectiveness and safety. To our knowle dge, the standardized use of erytrhomycin and nicotinamide in a group of pa tients suffering from EP has never been reported.