This protocol covers bullous pemphigoid presenting in its localized form, where blistering and associated pruritic symptoms are limited to a single body site, and outlines the structured first-line management approach for this pattern.

Clinical Scenario

Localized bullous pemphigoid is defined by the presence of lesions involving one body site. This circumscribed distribution distinguishes it from more extensive presentations and directly shapes treatment selection.

Treatment Approach

First-line management is based on a potent topical corticosteroid applied to the affected area. The full protocol specifies the application method, continuation criteria, and the structured tapering schedule that follows disease control.

Treatment Goal

Control of disease activity: new lesions and pruritic symptoms cease to form, and established lesions begin to heal.

References

Localized BP is defined by the presence of lesions involving one body site.
Initial treatment is based on topical clobetasol propionate 10 g per day, which is applied once daily over the involved area.
It is recommended to continue treatment until 15 days after CDA followed by a progressive tapering of CS doses over 4 months (4.64 ± 1.11).
According to the consensus statement, CDA is defined as the point at which new lesions or pruritic symptoms cease to form and established lesions begin to heal.

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Treatment of Localized Bullous Pemphigoid — Lesions Confined to One Body Site

References