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https://doi.org/10.4081/dr.2025.10484

A rare case of keloid combined with bullous pemphigoid

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Published: 9 October 2025
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Keloid, bullous pemphigoid, dupilumab, biological therapy

Authors

Ying Zhang
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Yiyi Gong
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Xiangguang Shi
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Huyan Chen
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Yining Wei
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Wenyu Wu
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.
Mengguo Liu
liumengguo@126.com
Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China.

Keloids and bullous pemphigoid (BP) are two clinically and pathophysiologically distinct dermatologic disorders – the former involves abnormal scar formation due to excess collagen deposition, while the latter is an autoimmune blistering disease. We report a case of a 67-year-old man with a 19-year history of abdominal keloids and the subsequent appearance of vesicular skin lesions. Histopathologic examination revealed both keloidal fibrosis and subepidermal blister formation. Serum testing demonstrated elevated anti-BP180 antibody levels. Initial treatment with topical and systemic agents, including neomycin, glycyrrhizin, spironolactone, and minocycline, resulted in limited improvement. Subsequently, dupilumab – a monoclonal antibody against the interleukin (IL)-4 receptor α – was introduced. After two months of dupilumab therapy, the vesicular lesions resolved, keloids stabilized, serum anti-BP180 antibody levels normalized, and the Dermatology Life Quality Index (DLQI) score decreased from 11 to 2.

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1. Kim HJ, Kim YH. Comprehensive Insights into Keloid Pathogenesis and Advanced Therapeutic Strategies. Int J Mol Sci 2024;25:8776. DOI: https://doi.org/10.3390/ijms25168776
2. Limandjaja GC, Niessen FB, Scheper RJ, Gibbs S. The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models. Front. Cell Dev Biol 2020;8. DOI: https://doi.org/10.3389/fcell.2020.00360
3. Wu J, Del Duca E, Espino M, et al. Guttman-Yassky, E. RNA Sequencing Keloid Transcriptome Associates Keloids With Th2, Th1, Th17/Th22, and JAK3-Skewing. Front Immunol 2020;11. DOI: https://doi.org/10.3389/fimmu.2020.597741
4. Zhang L, Chen Z, Wang L, Luo X. Bullous Pemphigoid: The Role of Type 2 Inflammation in Its Pathogenesis and the Prospect of Targeted Therapy. Front Immunol 2023;14. DOI: https://doi.org/10.3389/fimmu.2023.1115083
5. Moro F, Fania L, Sinagra JLM, et al. Bullous Pemphigoid: Trigger and Predisposing Factors. Biomolecules 2020;10:1432. DOI: https://doi.org/10.3390/biom10101432
6. Egami S, Yamagami J, Amagai M. Autoimmune Bullous Skin Diseases, Pemphigus and Pemphigoid. J Allergy Clin Immunol 2020;145:1031-47. DOI: https://doi.org/10.1016/j.jaci.2020.02.013
7. Olbrich H, Sadik CD, Ludwig RJ, et al. Dupilumab in Inflammatory Skin Diseases: A Systematic Review. Biomolecules 2023;13:634. DOI: https://doi.org/10.3390/biom13040634
8. Nguyen JK, Austin E, Huang A, et al. The IL-4/IL-13 Axis in Skin Fibrosis and Scarring: Mechanistic Concepts and Therapeutic Targets. Arch Dermatol Res 2020;312:81-92. DOI: https://doi.org/10.1007/s00403-019-01972-3
9. Zhao L, Wang Q, Liang G, et al. Evaluation of Dupilumab in Patients With Bullous Pemphigoid. JAMA Dermatol 2023;159:953. DOI: https://doi.org/10.1001/jamadermatol.2023.2428
10. Liang J, Abulikemu K, Maolidan, et al. Nine Cases of Refractory Bullous Pemphigoid Treated with Dupilumab and Literature Review. Int Immunopharmacol 2023;116:109788. DOI: https://doi.org/10.1016/j.intimp.2023.109788
11. Cao P, Xu W, Zhang L. Rituximab, Omalizumab, and Dupilumab Treatment Outcomes in Bullous Pemphigoid: A Systematic Review. Front Immunol 2022;13:928621. DOI: https://doi.org/10.3389/fimmu.2022.928621
12. Wong AJS, Song EJ. Dupilumab as an adjuvant treatment for keloid-associated symptoms. JAAD Case Rep 2021;13:73-4. DOI: https://doi.org/10.1016/j.jdcr.2021.04.034
13. Bitterman D, Patel P, Wang JY, et al. Systematic review of dupilumab safety and efficacy for treatment of keloid scars. Arch Dermatol Res 2024;316:560. DOI: https://doi.org/10.1007/s00403-024-03277-6
14. Min MS, Mazori DR, Lee MS, et al. Successful Treatment of Keloids and Hypertrophic Scars With Systemic and Intralesional Dupilumab. J Drugs Dermatol 2023;22:1220-2. DOI: https://doi.org/10.36849/JDD.6385

Supporting Agencies

This study was supported by grants from the National Natural Science Foundation of China (No. 81602747).
Wenyu Wu, Department of Dermatology, Huashan Hospital, Fudan University, Shanghai

National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai; Ministry of Education Key Laboratory of Contemporary Anthropology, School of Life Sciences, and Academy for Engineering and Technology, Fudan University, Shanghai, China.

How to Cite



1.
Zhang Y, Gong Y, Shi X, Chen H, Wei Y, Wu W, et al. A rare case of keloid combined with bullous pemphigoid. Dermatol Reports [Internet]. 2025 Oct. 9 [cited 2026 May 24];. Available from: https://journals.pagepress.net/dr/article/view/10484
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