{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T06:04:16Z","timestamp":1790057056841,"version":"4.0.1"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Bullous pemphigoid (BP) is a common autoimmune subepidermal blistering disorder that mainly affects elderly individuals aged \u226570 years. Systemic glucocorticoids serve as first-line treatment, and immunosuppressants or biological agents such as dupilumab are added for patients with suboptimal responses. However, a proportion of patients exhibit suboptimal responses or cannot sustain therapeutic benefits under these standard therapeutic regimens, representing an important unmet clinical need. We describe a 74-year-old patient with refractory BP who did not achieve adequate disease control despite sequential treatment with methylprednisolone, mycophenolate mofetil, cyclosporine, and dupilumab. The addition of upadacitinib resulted in substantial clinical improvement and durable disease stability. We also examine existing literature concerning salvage therapeutic options for refractory BP and the real-world application of upadacitinib in this disease. As this is a single-case observation, our work intends to offer clinical insights for the management of difficult-to-treat BP.<\/jats:p>","DOI":"10.3389\/fimmu.2026.1866166","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:38:55Z","timestamp":1790055535000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Upadacitinib for the treatment of refractory bullous pemphigoid: a case report and literature review"],"prefix":"10.3389","volume":"17","author":[{"given":"Fangying","family":"Su","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guanjing","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qunshi","family":"Qin","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minmin","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhi","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereology, The People\u2019s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences","place":["Nanning, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20199007","article-title":"Bullous pemphigoid","volume":"94","author":"Miyamoto","year":"2019","journal-title":"Anais Brasileiros Dermatologia"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3390\/medicina57101061","article-title":"Bullous pemphigoid and other pemphigoid dermatoses","volume":"57","author":"Pratasava","year":"2021","journal-title":"Med 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