Prevention and Treatment of Infections in Patients with Autoimmune Blistering Disease

Patients with autoimmune blistering diseases (AIBDs) are particularly susceptible to infection with pathogenic bacteria, fungi, viruses, and mycobacteria. When treated with systemic immunosuppressive medications, these patients may also develop opportunistic infections. Morbidity and mortality associated with infection are considerable in this patient population. Prompt recognition of infection is critical for early and appropriate medical intervention. Preventive measures include avoidance of high-risk environments, diligent attention to skin care and hygiene, administration of immunizations (when contraindications are absent), patient education regarding the symptoms and signs of impending infection, and minimization of iatrogenic immunosuppression where possible. Topical antimicrobial agents can be used for skin colonization or localized infection. The use of systemic antimicrobial agents should be guided by culture and sensitivity results if available. A multidisciplinary approach to care in patients with complex medical issues or acute illness is recommended.