Differential diagnosis It should be differentiated from acquired epidermolysis bullosa (EBA). Common to both diseases are the onset in old age; tonic macules; pathologically subepidermal blisters; and DIF as fluorescence due to BMZ banded IgG and/or C3 deposition. Key points of differentiation: 1, BP is more likely to occur on the flexors of the limbs, while EBA is more likely to occur on the extremities of the limbs susceptible to friction and trauma and on the extensor side of the elbows and knees; 2, the infiltration of BP is mainly eosinophils, while EBA is mainly neutrophils; 3, the “salt cleft skin” as DIF, BP fluorescence staining on the epidermal side of the salt cleft skin, while The fluorescence of EBA is on the dermal side of the salt cleft skin. Treatment The principle is early diagnosis and early treatment. The more timely the treatment, the faster the lesion control and the better the prognosis. The first choice is glucocorticoids, often prednisone, and the dosage depends on the extent of the lesions and the severity of the lesions. The initial dose is usually 30mg/day for mild cases with lesions covering less than 10% of the body surface, 40-50 (mg/day) for moderate cases with lesions covering 30% of the body surface, and 60-80 (mg/day) for severe cases with lesions covering more than 50% of the body surface. After the lesions have been controlled and maintained for one to two weeks, the drug should be gradually reduced to a maintenance dose. When the dose is reduced to 15-20 mg/day, the dose can be gradually changed to every other day. In the process of drug reduction, the disease should be closely observed, once there is a new rash, then the drug should be temporarily reduced. In severe cases, when the disease cannot be controlled with high doses of corticosteroids, immunosuppressants such as methotrexate, cyclophosphamide, cyclosporine, and rhodopsin may be used in combination, as described in the section on pemphigus. Most patients with herpetiform aspergillosis are old and often have other diseases. When diabetes and tuberculosis prevent the use of corticosteroids, oral tetracycline 500 mg 4 times a day or memantine 100 mg twice a day and nicotinamide 200 mg 3 times a day can be used, which is effective for some patients, especially those with mild disease. Supportive therapy treatment is important, and since most of the patients are old, attention should be paid to strengthening nutrition and maintaining the hydropower mediator balance. During the treatment period, attention should be paid to the side effects of corticosteroids and the resulting comorbidities.