Abstract: Bullous pemphigoid (BP) is a common autoimmune bullous derma, which mainly occurs in the elderly patients, and such patients often have a history of multiple neurological diseases, thrombosis and embolism, so the application of glucocorticoids in the treatment of elderly BP patients is a great challenge. Herein, we report  a case of successful treatment of elderly BP patients complicated with multi-system chronic history with dupriuzumab alone.  A 91-year-old female presented with itching erythema, blister on the trunk and limbs for half a year. The patient had a history of hypertension for more than 2 years, myocardial infarction for 4 years and cerebral infarction for 2 years. The diagnosis of BP was diagnosed based on the results of biopsy immunohistochemistry and serum antibodies, and the baseline BPDAI score was 18. The patient was treated with dupriuzumab, and the initial dose was 600 mg ,then 300 mg was given after 2 weeks. The lesions subsided and  pigmentation remained 3 weeks after the second dose, and the BPDAI score decreased to 4. The patient did not relapse after 3 months of follow-up.

Key words: bullous pemphigoid, dupilumab