Dupilumab in the Treatment of Pemphigoid Gestationis

Pemphigoid gestationis (PG) is a rare autoimmune bullous disease that is speculated to result from an excessive type 2 inflammatory immune response. It manifests as pruritic erythematous papules or urticarial plaques that progress to blistering lesions in the second or third trimester of pregnancy. Clinically and histologically, PG resembles bullous pemphigoid and is similarly associated with the presence of IgG autoantibodies against the collagenous transmembrane protein BP180. Dupilumab is a novel IgG4 human monoclonal antibody that blocks the signaling of IL-4Rα, which inhibits this Th2 inflammatory response. In this article, we highlight 2 patients with PG who were successfully treated with dupilumab.