Abstract: This report presents a case of pemphigoid gestationis (PG) refractory to corticosteroid therapy, which was successfully treated with dupilumab. At 23 weeks of gestation, the patient presented with widespread erythema and blisters. The diagnosis of PG was confirmed by histopathology showing subepidermal blister with a predominant eosinophilic infiltrate and direct immunofluorescence demonstrating linear deposition of complement C3 along the basement membrane zone. The skin lesions were controlled within 3 days after the initial 600 mg dose of dupilumab. Subsequent maintenance therapy with 300 mg every 2 weeks enabled rapid tapering of systemic corticosteroids. The patient eventually delivered a healthy male infant at full term. A review of 8 additional PG cases from the literature indicates that dupilumab offers rapid onset of action, facilitates steroid-sparing, and demonstrates a favorable safety profile for both mother and infant. These findings suggest dupilumab as a novel, safe, and effective treatment strategy for refractory pemphigoid gestationis.

Key words: pemphigoid gestationis, dupilumab