Immune checkpoint inhibitor-induced bullous pemphigoid: A clinical review

作者：Raphaella Lambert, Brandon Block, Benjamin D. Hu, Sach Thakker, Camille M. Powers, Grace Rabinowitz, Hannah Verma, Zachary Hopkins, Nicholas Gulati, Jónas A. Aðalsteinsson · 发表于：JAAD reviews. · 年份：2025 · DOI：10.1016/j.jdrv.2025.11.002 · 被引用次数：3 · 研究领域：Autoimmune Bullous Skin Diseases、Cancer Immunotherapy and Biomarkers、IgG4-Related and Inflammatory Diseases

Immune checkpoint inhibitor-induced bullous pemphigoid (ICI-BP) is a rare yet debilitating cutaneous immune-related adverse event characterized by auto-antibody attachment to subepidermal anchoring proteins causing tense bullae and pruritus. Clinical presentation of ICI-BP is variable and may be characterized by extended latent periods or prolonged periods of rash-free pruritus, often hindering prompt diagnosis. Accurate diagnosis of ICI-BP may warrant both tissue and serum analysis with direct immunofluorescence, enzyme-linked immunosorbent assay and/or indirect immunofluorescence. Currently, a standardized treatment approach is lacking; however, the advent of biologics, including dupilumab, omalizumab, and rituximab, and Janus kinase inhibitors targeting the underlying immunopathogenesis of ICI-BP may provide more targeted therapeutic options and reduce the need for suppressive therapies and/or cessation of immunotherapy. In this article, we provide a comprehensive review of the existing literature detailing the clinical presentation, diagnosis, management, and prognosis of ICI-BP, highlighting our own clinical experience and recommendations.