Objective To explore the clinical features and treatments of Chinese patients with bullous pemphigoid(BP)induced by immune checkpoint inhibitors(ICI).Methods A retrospective analysis was con-ducted on 18 Chinese patients with ICI-induced BP treated in the Peking Union Medical College Hospital and 14 Chinese patients with this disease reported in the literature.Furthermore,the research data of non-Chinese pa-tients were used for comparison to outline the clinical features and treatment responses of the Chinese pa-tients.Results A total of 32 patients(21 males and 11 females)were enrolled,and all of them presented BP induced by programmed death-1/programmed death ligand-1 inhibitors.Compared with non-Chinese patients,the Chinese patients with ICI-induced BP showed low average ages[(65.2±9.5)years vs.(69.9±10.3)years,P=0.020],increased proportion of BP induced by tislelizumab(28.1％vs.0,P＜0.001),decreased pro-portions of BP induced by pembrolizumab(18.8％vs.39.4％,P=0.029)and nivolumab(3.1％vs.52.8％,P＜0.001),and decreased proportion of primary malignant melanoma(9.4％vs.43.3％,P＜0.001).The incidence of pruritus(96.9％vs.66.1％,P＜0.001)and mucosal involvement(59.4％vs.15.7％,P＜0.001)in the Chinese patients were higher than those in the non-Chinese patients.The proportions of the Chinese patients treated with tripterygium glycosides(9.4％vs.0,P=0.008),dupilumab(18.8％vs.0.8％,P＜0.001),and topical corticosteroids(87.5％vs.53.5％,P＜0.001)were higher than those of non-Chinese patients.Conclusions The Chinese patients with ICI-induced BP tend to have a younger age and a higher probability of BP induced by tislelizumab than the non-Chinese patients.Unlike that in the non-Chinese pa-tients,the primary tumor in the Chinese patients with ICI-induced BP is predominantly lung cancer.Pruritus is more obvious,and mucosal involvement is more common in the Chinese patients.Systemic corticosteroid therapy is the international standard treatment for ICI-induced BP,while tripterygium glycosides and dupilumab are char-acteristic therapies in China.
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