Hello and welcome to healthcaremagic Bullous pemphigoid is an autoimmune blistering disease characterised by tense subepidermal bullae and variable itching OR urticaria. It has a remitting and relapsing course and thus can recur. Usually the disease is self limiting and goes into remission on its own. Oral steroids are the drug of choice for bullous pemphigoid and bring about rapid control of the disease. Immunosuppressants like Mycophenolate Mofetil, Azathioprine, Methotrexate are also effective in bullous pemphigoid. They are slow acting unlike steroids but the main advantage is that, they are steroid sparing agents. Steroids have a lot of adverse effects like weight gain, weakening of the bones (osteoporosis), diabetes, high blood pressure, glaucoma, cataracts etc they cannot be continued alone forever. Steroids can be tapered gradually and finally stopped once the steroids sparing agents take full control of the disease. Steroid sparing agents are also suitable for maintenance of remission. Regards