Three cases of refractory bullous pemphigoid in the elderly treated successfully with ultra-low-dose rituximab.

Rituximab has proven effective for the treatment of steroid-refractory bullous pemphigoid (BP), but there is controversy over the dosing protocol. We report three cases of refractory BP treated successfully with ultra-low-dose rituximab (100 mg weekly for 4 weeks). Our cases confirmed the efficacy and good follow-up outcomes of this treatment strategy for refractory BP. The ultra-low-dose rituximab regimen (100 mg weekly for 4 weeks) may be a useful alternative therapy in patients with refractory BP.