Bullous pemphigoid treated with Janus kinase inhibitor upadacitinib
David L. Nash, Mark G. Kirchhof
Abstract
Bullous pemphigoid (BP) is a chronic autoimmune blistering disorder defined by autoantibody formation to hemidesmosomal proteins in the basement membrane zone of the skin. This disease presents most commonly in elderly individuals as tense bullae on erythematous or normal skin, often affecting the trunk and extremities and accompanied by significant pruritus.1 Prompt therapeutic intervention allows for healing of eroded lesions and a reduction in morbidity/mortality (eg, secondary infections).1 Depending on the amount of cutaneous involvement, topical or systemic corticosteroids are traditionally used as the first-line treatment, and systemic immunosuppressive drugs, such as methotrexate or mycophenolate mofetil, are deployed as second-line agents in those with extensive or persistent disease.