Abstract: 【Abstract】 Bullous pemphigoid （BP） is the most common autoimmune bullous disease in clinical practice. Topical or systemic glucocorticoids are the first-line treatment for BP, and most patients respond well to glucocorticoids and can achieve the goal of healing after consolidation and maintenance treatments. However, there are some difficulties in the treatment of BP, such as severe and uncontrolled BP, recalcitrant BP, relapsing BP, and the presence of complex comorbidities or complications, which pose clinical challenges. Based on the rational, scientific and safe use of glucocorticoids, as well as the analysis and evaluation of each patient′s specific condition, optimizing the glucocorticoid dosage and using glucocorticoids alone or in combination with immunomodulators, immunosuppressants, biological agents, and small-molecule targeted drugs may effectively help resolve the difficulties in BP treatment and stabilize patients′ condition.

Key words: Pemphigoid, bullous, Therapy, Glucocorticoids, Immunosuppressive agents, Biologics, Small-molecule targeted drugs