We describe four patients with generalized bullous pemphigoid, who received treatment with oral prednisone and suffered serious corticosteroid-induced iatrogenesis. In all cases, we decided to quickly withdraw the systemic corticosteroid treatment and begin treatment with 0.05 % clobetasol propionate (20 g/day). New outbreaks of pemphigoid or significant side effects were not seen after this change in medication. The topical treatment went on for five to twelve months, and the patients were followed up for extended periods after treatment ended, with no recurrences being observed. Systemic corticosteroid treatment may be replaced by topical treatment without complications, and this may be especially indicated in patients with serious corticosteroid-induced iatrogenesis.
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