Successful treatment of recalcitrant mucous membrane pemphigoid with multisystem involvement with baricitinib and methotrexate

Mucous membrane pemphigoid (MMP), previously known as cicatricial pemphigoid, is an autoimmune blistering disease predominantly affecting mucosae of the mouth and eyes. In severe cases, complications such as blindness and esophageal/tracheal strictures cause significant morbidity.1 Herein, we present the case of an elderly woman with recalcitrant MMP with oral, ocular, and esophageal involvement, recalcitrant to several therapies now responding to baricitinib and methotrexate.