Case Report: Dupilumab as a steroid-sparing therapeutic option in refractory anti-p200 pemphigoid: real-world effectiveness in a patient with significant comorbidities.

Anti-p200 pemphigoid is a rare autoimmune subepidermal blistering disease with limited evidence guiding its management. We report a 49-year-old woman with refractory anti-p200 pemphigoid who failed treatment with high-dose prednisone and dapsone and developed significant corticosteroid-related toxicity, including hypertension, hypertrichosis, steroid-induced myopathy, and psychological distress. Given her history of complicated diverticulitis requiring bowel resection, dupilumab was initiated as a steroid-sparing therapeutic option. Pruritus improved within two weeks, near-complete remission was achieved after two months, and sustained disease control was maintained for six months, allowing substantial corticosteroid tapering without treatment-related adverse events.