Specific serum and skin immunological profiles of patients with bullous pemphigoid requiring biologics

Bullous pemphigoid mainly affects older people with various comorbidities. The disease has a high mortality rate due to the disease itself and to the side effects of systemic treatments. The aim of this study was to identify blood and skin predictive factors for therapeutic response at diagnosis, so that patients can be offered the most appropriate treatment for their condition as quickly as possible. A prominent Th2 response was identified in patients whose disease was resistant to first-line treatment. It was possible to predict resistance to first-line treatment in BP through skin IL-4-, IL-13- and IL-5-expressing cells. In contrast, CD68 and skin IFN-γ-expressing cells (Th1 profile) were associated with sensitivity to first-line treatment.