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Drug-induced bullous pemphigoid

Last edited: 4/10/2026

Overview

Drug-induced bullous pemphigoid (BIBP) is an adverse event associated with certain therapeutic agents, particularly biologic drugs used in the treatment of psoriasis 1. The exact incidence of BIBP in psoriatic patients remains unknown 1.

Diagnosis

  • Causal relationship between BP and biologic drug assessed using Naranjo scale and Karch-Lasagna algorithm 1.

    • Management

  • Monitoring of skin condition is recommended 1.

    • Key Recommendations

  • Close monitoring of skin condition is recommended for patients treated with biologic drugs for psoriasis 1. (Evidence: Weak)
  • Ustekinumab has the largest evidence of inducing BIBP, particularly in patients who have previously failed TNF-α inhibitors 1. (Evidence: Weak)
  • Distinct patterns in cytokinic pathways and clinical course exist between BP induced by TNF-α blockers and ustekinumab 1. (Evidence: Weak)

    • References

    1 Husein-ElAhmed H, Steinhoff M. Bullous pemphigoid induced by biologic drugs in psoriasis: a systematic review. The Journal of dermatological treatment 2022. link

    Original source

    1. [1]
      Bullous pemphigoid induced by biologic drugs in psoriasis: a systematic review. — Husein-ElAhmed H, Steinhoff M The Journal of dermatological treatment (2022)
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