Epidermolysis bullosa acquisita (EBA) is a rare acquired chronic autoimmune subepidermal bullous disease characterized by auto-antibodies against type-VII collagen (COL7).Systemic immunosuppressant treatment options often have limited efficacy in treating EBA, however, rituximab, a monoclonal antibody targeting CD2O antigen on B lymphocytes, has shown promise in inducing long-term remission for patients unresponsive to conventional therapies.This case report highlights a patient with severe, recalcitrant EBA who has achieved and maintained clin. remission (CR) off therapy for 5 years following rituximab monotherapy.The immunol. mechanisms responsible for longlasting remission in EBA patients after rituximab therapy remain incompletely understood.Studies in pemphigus patients treated with rituximab infusions have found that sustained CR is correlated with a prolonged repopulation with naive B cells and a delayed reappearance of memory B cells.This blockage of B cell maturation results in the long-term disappearance of circulating desmoglein specific B cells.It is possible that a similar mechanism may lead to the sustained absence of COL7-specific B cells, potentially leading to long-term clin. remission in EBA patients.This case adds to the existing evidence for rituximab in the management of EBA and demonstrates its long-term efficacy in managing severe recalcitrant EBA.