{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T02:22:21Z","timestamp":1774059741389,"version":"3.50.1"},"reference-count":10,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T00:00:00Z","timestamp":1769126400000},"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. Med."],"abstract":"<jats:p>Bullous pemphigoid (BP) is the most common autoimmune blistering disease affecting the skin. It is characterized by a type 2 immune-mediated pathogenesis. BP predominantly affects elderly patients who have multiple comorbidities, and treatment can be particularly challenging in refractory cases or when standard immunosuppressive therapies are limited due to toxicity or contraindications. Here, we present a case series of five patients with confirmed BP who were treated with off-label dupilumab. All five patients achieved sustained clinical improvement with dupilumab treatment, including reductions in disease activity and pruritus. No severe adverse events were reported, except for one case of manageable conjunctivitis. Dupilumab was well tolerated and resulted in marked clinical benefit in all five BP patients included in this case series. These findings support the growing evidence for dupilumab\u2019s potential role as a safe and effective treatment option for BP. Further long-term clinical trials are needed to assess its disease-modifying potential.<\/jats:p>","DOI":"10.3389\/fmed.2025.1697048","type":"journal-article","created":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T05:16:19Z","timestamp":1769145379000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case Report: Dupilumab in difficult-to-treat bullous pemphigoid at the University Hospital Schleswig-Holstein, Campus Kiel"],"prefix":"10.3389","volume":"12","author":[{"given":"Y.","family":"Mehrjerdian","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel","place":["Kiel, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Atallah","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel","place":["Kiel, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Wijaya","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel","place":["Kiel, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. M.","family":"Hammers","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel","place":["Kiel, Germany"]},{"name":"Department of Biomedicine, University of Basel","place":["Basel, Switzerland"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Gerdes","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel","place":["Kiel, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Heine","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Allergy, University Hospital Schleswig-Holstein, Campus Kiel","place":["Kiel, Germany"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1197","DOI":"10.1111\/jdv.17107","article-title":"Incidence of pemphigoid diseases in northern Germany in 2016 \u2013 first data from the Schleswig-Holstein registry of autoimmune bullous diseases","volume":"35","author":"van Beek","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"175","DOI":"10.1146\/annurev-pathol-012615-044313","article-title":"Mechanisms of disease: pemphigus and bullous pemphigoid","volume":"11","author":"Hammers","year":"2016","journal-title":"Annu Rev Pathol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1115083","DOI":"10.3389\/fimmu.2023.1115083","article-title":"Bullous pemphigoid: the role of type 2 inflammation in its pathogenesis and the prospect of targeted therapy","volume":"14","author":"Zhang","year":"2023","journal-title":"Front Immunol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"2991","DOI":"10.1007\/s12325-024-02810-3","article-title":"Study design of a phase 2\/3 randomized controlled trial of dupilumab in adults with bullous pemphigoid: LIBERTY-BP ADEPT","volume":"41","author":"Murrell","year":"2024","journal-title":"Adv Ther"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1093\/bjd\/ljae403","article-title":"Real-world evaluation of the effectiveness and safety of dupilumab in bullous pemphigoid: an ambispective multicentre case series","volume":"192","author":"Planella-Fontanillas","year":"2024","journal-title":"Br J Dermatol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"738907","DOI":"10.3389\/fimmu.2021.738907","article-title":"Efficacy and safety of dupilumab in moderate-to-severe bullous pemphigoid","volume":"12","author":"Zhang","year":"2021","journal-title":"Front Immunol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1001\/archderm.136.2.174","article-title":"Serum levels of autoantibodies to BP180 correlate with disease activity in patients with bullous pemphigoid","volume":"136","author":"Schmidt","year":"2000","journal-title":"Arch Dermatol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"849790","DOI":"10.3389\/fimmu.2022.849790","article-title":"The diversity of serum anti-DSG3 IgG subclasses has a major impact on pemphigus activity and is predictive of relapses after treatment with rituximab","volume":"13","author":"Golinski","year":"2022","journal-title":"Front Immunol"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"4418","DOI":"10.1007\/s12325-024-02992-w","article-title":"Pathophysiology of bullous pemphigoid: role of type 2 inflammation and emerging treatment strategies (narrative review)","volume":"41","author":"Werth","year":"2024","journal-title":"Adv Ther"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1196946","DOI":"10.3389\/fmed.2023.1196946","article-title":"Targeting type 2 inflammation in bullous pemphigoid: current and emerging therapeutic approaches","volume":"10","author":"Toh","year":"2023","journal-title":"Front Med"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1697048\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T05:16:19Z","timestamp":1769145379000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1697048\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,23]]},"references-count":10,"alternative-id":["10.3389\/fmed.2025.1697048"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1697048","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,23]]},"article-number":"1697048"}}