Bullous pemphigoid (BP) is the most common cutaneous autoimmune blistering disease. BP autoantibodies target 2 hemidesmosomal proteins of the basement membrane zone, BP180 and BP230. Anti-BP 180 autoantibodies are detected in many BP cases, and serum levels correlate with disease activity. In this multicenter prospective study of consecutive BP cases, Fichel and colleagues demonstrated that superpotent topical corticosteroids alone produced a marked decrease in anti-BP 180 autoantibodies in most patients, corresponding with an early therapeutic response. In addition, dementia and extensive initial disease were independent risk factors for BP relapse during the first year of treatment. In an Invited Commentary, Fine discusses the findings in the context of previous research.