Concurrent bullous pemphigoid and plaque psoriasis successfully treated with Janus kinase inhibitor Baricitinib

Abstract

We report a case of aggressive bullous pemphigoid (BP) concurrent with plaque psoriasis successfully treated with Janus kinase inhibitor Baricitinib. The 83-year-old Chinese man suffered 10 years of psoriasis and developed BP with typical intense blisters and significantly elevated serum anti-BP180 autoantibodies. Due to concerns

Bullous pemphigoid treated with Janus kinase inhibitor upadacitinib

“…The use of JAK inhibition in BP has also been reported by Xiao et al, 8 who successfully treated a patient with psoriasis and BP with the JAK1/JAK2 inhibitor, baricitinib. Elevated expressions of JAK/STAT proteins have been found in lesions of patients with BP and dermatitis herpetiformis, 9 and Xiao et al 8 postulate that the disruption of the JAK/STAT signaling pathway may dampen the autoimmune response in BP, with subsequent reduction in development of bullae. Baricitinib has also been documented to halt the progression of a related disorder, mucous membrane pemphigoid, in a patient who failed other systemic agents.…”

Two cases of bullous pemphigoid effectively treated with oral tofacitinib

“…A recent case report suggested a potential for the use of barcitinib, another JAKi, as a novel alternative therapy for concomitant plaque psoriasis and BP, or either condition. 7 Moreover, tofacitinib demonstrated antipruritic effects in other autoimmune skin diseases (atopic dermatitis, psoriasis). 8 , 9 Noteworthily, Juczynska et al found significantly greater expression of JAK/STAT proteins in skin lesions of BP patients compared to controls, 10 which connotes a favorable outcome in targeting this signaling pathway for the treatment of BP.…”

The cytokine milieu of bullous pemphigoid: Current and novel therapeutic targets

“…Results from ongoing clinical trials are thereby necessary to understand the impact of this treatment approach also in BP patients without coexisting psoriasis (58). Inhibition of janus kinase may worth being investigated in BP, since this could allow simultaneous targeting of both IL-4 and IL-23 (59)(60)(61)(62).…”