It depends on the extent of the disease and the severity of symptoms. Home wet wraps, when they can be done, can be essentially as effective as oral steroids in many situations, but can be time intensive. I provide the patient with instructions and a pound jar of triamcinolone ointment. Be careful s...

Cellcept is a good alternative. It works but sometimes causes edema. The biologics, even off-label, are something to consider as well.