Treatment of refractory epidermolysis bullosa acquisita with extracorporeal photochemotherapy

Treatment of epidermolysis bullosa acquisita (EBA) with conventional therapy frequently does not result in improvement. Extracorporeal photochemotherapy (ECP) is a novel immunomodulating technique which might be of benefit in the treatment of autoimmune disease. We prospectively studied three patients with refractory EBA who were treated with ECP. All three patients had improvement in objective measurements of their disease severity while two of the three had significant subjective improvement in their skin fragility and the clinical activity of their disease. Both the objective and subjective manifestations of the disease continued to improve 6 months after completion of the protocol. ECP may be a therapeutic option in the treatment of patients with EBA who are refractory to conventional therapy.