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Omalizumab, a monoclonal anti-IgE antibody, has been used off-label in a few case series of bullous pemphigoids (BPs) with rapid efficacy and high safety profile. However, there is a lack of data to select patients who would get the most therapeutic benefit from omalizumab therapy. To assess if eosinophil-to-lymphocyte ratio (ELR), total serum IgE level, and serum eosinophil percentage would be useful in predicting response to omalizumab therapy in patients with BP. Medical records of 10 patients with BP treated with omalizumab were retrospectively analysed for clinical and laboratory data. ELRs, total serum IgE levels, and serum eosinophil percentages were compared between groups of complete responders and partial responders/flare-ups, but the results were not statistically significant. Studies with larger sample sizes should be done to predict the role of type 2 immunity markers in omalizumab therapy of BP patients. Keywords: Bullous pemphigoid, eosinophil, lymphocyte, omalizumab, type 2 immunity, Author(s): Gülfem Akin (corresponding author) [1]; Ceylan Avci [1]; Sevgi Akarsu [1] Introduction Bullous pemphigoid (BP) is an autoimmune blistering disease that occurs in elderly patients older than 60 years. [...]

Blistering diseases such as pemphigus and bullous pemphigoid are caused by an autoimmune reaction toward proteins in skin. These proteins include those that attach skin cells to the basement membrane and those that attach skin cells to each other. This results in a protective barrier to microorganisms. When this barrier is broken by autoantibodies, blisters occur. The blisters can be painful and disfiguring, and loss of the protective barrier can lead to infection. Most people with blistering diseases are treated with drugs that suppress the immune system.