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Bullous pemphigoid (BP), a subepidermal blistering disease, occurs in older patients. Associated with morbidity, it is often accompanied by intense pruritus. Its traditional immunologic profile includes deposition and circulation of IgG antibodies, but it has also been associated with increased serum IgE and, in perhaps 25% of patients, deposition of IgE at the basement membrane zone. Eosinophilia in tissue and the circulation are also common. Usual treatment is systemic corticosteroids or immunosuppressive agents. Patients sometimes respond to a tetracycline antibiotic plus niacinamide, rituximab, or high-dose immunoglobulin infusions.
These authors report an open-label trial of subcutaneous omalizumab, 300 or 375 mg, in six BP patients. Th…