Jobst Katerina, Künzel Stephan R, Beissert Stefan, Abraham Susanne
Department of Dermatology, Faculty of Medicine Carl Gustav Carus, University Allergy Center, Technische Universität Dresden, Dresden, Germany.
Institute for Transfusion Medicine, Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.
Front Pharmacol. 2025 Aug 29;16:1656089. doi: 10.3389/fphar.2025.1656089. eCollection 2025.
Bullous pemphigoid (BP) and atopic dermatitis (AD) are chronic inflammatory skin diseases that may share overlapping immunopathogenic mechanisms, particularly a type 2 immune response. Emerging evidence suggests that dupilumab, an IL-4Rα antagonist, may be effective in treating both conditions.
In this retrospective case series, twelve patients (mean age: 78.6 years; range: 67-93 years) with moderate to severe BP and a history of AD were included. All patients received dupilumab and were monitored over 12 weeks. Clinical activity was assessed using BPDAI scores, pruritus NRS, and DLQI.
At week 12, complete remission of bullous skin lesions was observed in all patients (100%), with 83.3% already achieving this by week 4. Pruritus improved significantly (p < 0.0001), with 58.3% achieving complete resolution (NRS 0/10) at week 12. Notably, two patients had previously received tralokinumab without clinical improvement, underscoring the distinct efficacy of dupilumab in this setting. Patient satisfaction was uniformly high (score 5/5). No adverse events were reported. Dupilumab was well tolerated, even in elderly, multimorbid patients.
Dupilumab appears to be a safe and highly effective treatment for patients with concurrent BP and AD, leading to rapid and sustained symptom control, resolution of skin lesions, and high patient satisfaction.
大疱性类天疱疮（BP）和特应性皮炎（AD）是慢性炎症性皮肤病，可能具有重叠的免疫致病机制，尤其是2型免疫反应。新出现的证据表明，IL-4Rα拮抗剂度普利尤单抗可能对治疗这两种疾病均有效。
在这个回顾性病例系列中，纳入了12例（平均年龄：78.6岁；范围：67 - 93岁）患有中度至重度BP且有AD病史的患者。所有患者均接受度普利尤单抗治疗，并进行了12周的监测。使用BPDAI评分、瘙痒数字评定量表（NRS）和皮肤病生活质量指数（DLQI）评估临床活动度。
在第12周时，所有患者（100%）的大疱性皮肤病变均完全缓解，其中83.3%在第4周时就已达到这一效果。瘙痒症状显著改善（p < 0.0001），58.3%的患者在第12周时瘙痒完全缓解（NRS 0/10）。值得注意的是，两名患者此前接受曲罗芦单抗治疗但无临床改善，这突出了度普利尤单抗在这种情况下的独特疗效。患者满意度普遍较高（评分5/5）。未报告不良事件。即使是老年、患有多种疾病的患者，度普利尤单抗的耐受性也良好。
度普利尤单抗似乎是并发BP和AD患者的一种安全且高效的治疗方法，可快速且持续地控制症状、消除皮肤病变，并使患者满意度较高。
