DEAR DR. ROACH: I am a 73-year-old woman who is in otherwise good health, but I was diagnosed with bullous pemphigoid, a rare autoimmune disease, in January 2022. I have been treated by three different dermatologists with doxycycline, prednisone and Dupixent. The only effective treatment has turned out to be prednisone.

I have been taking a dosage of 5-10 mg depending on the severity of the disease flare-up for the past three years. I really dislike the side effects of weight gain and bruising easily with prednisone. The skin blisters and intense itching cause me to take it for relief. My doctor has suggested looking into a treatment like Imuran, but the side effects seem daunting.

I would appreciate any thoughts you might have. -- D.B.

ANSWER: You’re exactly right that bullous pemphigo

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