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Updated: Mar 28, 2026

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Immune Checkpoint Inhibitor-Related Bullous Pemphigoid: Distinct Clinical and Immunological Profiles.

Min Zou1,2, Xun Feng1,2, Jishu Li1,2

  • 1Department of Dermatology and Venereology, West China Hospital, Sichuan University, Chengdu, China.

Experimental Dermatology
|March 27, 2026
PubMed
Summary

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Immune checkpoint inhibitor-induced bullous pemphigoid (ICI-BP) presents differently than classic BP, often requiring systemic glucocorticoids. Interleukin-4 inhibitors may help reduce anti-BP180 antibodies in ICI-BP patients.

Area of Science:

  • Immunodermatology
  • Oncology
  • Pharmacology

Background:

  • Immune checkpoint inhibitors (ICIs) can cause rare immune-related adverse events like bullous pemphigoid (BP).
  • Comparative data on ICI-induced BP (ICI-BP) versus non-ICI BP, particularly antibody dynamics, are limited.
  • Understanding these differences is crucial for patient prognosis and management.

Purpose of the Study:

  • To compare clinical presentation, immunological profiles, treatment, and outcomes of ICI-BP with non-ICI BP.
  • To investigate the dynamic changes of anti-BP antibodies in ICI-BP.
  • To evaluate treatment efficacies, including IL-4 inhibitors.

Main Methods:

  • Retrospective, single-center cohort study (2019-2025).
  • Comparison of three groups: ICI-BP (Group A), BP with concurrent malignancy without ICI (Group B), and classic BP (Group C).
Keywords:
BP180 antibodyIL‐4 inhibitorautoimmunitybullous pemphigoidimmune checkpoint inhibitor

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  • Analysis of clinical data, immunological markers, treatment responses, and outcomes.

    • Main Results:

    • ICI-BP patients were younger and had a significant male predominance compared to non-ICI BP.
    • A transient rise in anti-BP180 antibodies was noted in ICI-BP within the first two months.
    • ICI-BP more frequently required systemic glucocorticoids; IL-4 inhibitors showed efficacy in reducing anti-BP180 antibodies.

    Conclusions:

    • ICI-BP exhibits distinct clinical and immunological features compared to non-ICI BP.
    • Systemic glucocorticoid therapy is more common in ICI-BP.
    • IL-4 inhibitors may accelerate anti-BP180 antibody decline in ICI-BP, offering a potential therapeutic advantage.