Confirming BP Diagnosis and Choosing Treatment

Bullous pemphigoid (BP) is often suspected clinically but confirming the diagnosis and deciding how to treat it requires a thoughtful, stepwise approach.

In this video, Naveed Sami, MD, Professor of Dermatology and Medicine at the University of Central Florida, walks through what happens after bullous pemphigoid enters the differential. From biopsy and immunofluorescence testing to the role of serologic markers, he outlines how clinicians can establish the diagnosis with confidence before moving into treatment decisions.

Dr Sami also discusses the broader clinical picture that often accompanies BP. Because many patients are older and medically complex, treatment choices must balance disease control with safety. He reviews how clinicians typically assess disease severity, when traditional therapies such as systemic corticosteroids or antibiotic–nicotinamide combinations may be considered, and how emerging targeted approaches are beginning to shift the treatment landscape.

Ultimately, managing BP requires more than recognizing the disease itself. It means understanding the patient in front of you—their comorbidities, medications, and risk profile—and choosing therapies that control disease while minimizing harm.