Efficacy of dupilumab application in bullous pemphigoid proceeding in presence of bronchial asthma

Bullous pemphigoid is an autoimmune skin disease more commonly seen in elderly people. The disease was for the first time described in 1953 by W. F. Lever. It is characterized by the appearance of subepidermal vesicles caused by the formation of IgG-autoantibodies to the components of hemidesmosomes (BP180 (BPAg2) and BP230 (BPAg1) antigens) in the area of basal membrane of the skin, that may be related to various factors, including drug induction. Conventional treatment with systemic glucocorticosteroids, despite its sufficiently high efficacy, is often complicated taking into account the high probability of patients’ somatic burden, that makes it necessary to find and apply innovative treatment methods. Current studies demonstrate the significant role of type 2 inflammation (Th-2 inflammation) in the pathogenesis of bullous pemphigoid, that opens new possibilities for the application of genetically engineered biological agents for exposure to potential therapeutic targets. We present the clinical observation of a subject suffering from bullous pemphigoid, severe atopic bronchial asthma and receiving dupilumab with pronounced positive dynamics. The possibility of using targeted therapy in bullous pemphigoid sufferers, which allows to provide the best prognosis for patients with somatic complications is discussed.