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Bullous pemphigoid is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. It is also associated with high mortality and poor prognosis due to advanced age of the patients and coexisting comorbidities. There is a dearth of data in the literature regarding depression and anxiety among those patients. The objective of this brief review is to discuss the intertwining relationship between depression and anxiety with bullous pemphigoid.

Fig. 1. Clinical photographs of patients with juvenile bullous pemphigoid (BP). (A, B) Case 1: Pruritic papular lesions on the extremities were followed by formation of serous and haemorrhagic bullae on the soles and medial arches of the feet. (C, D) Case 2: Widespread bullous and crusted lesions on erythematous base mainly affecting the skin of the extremities. (E, F) Case 3: Widespread erythematous plaques and annular lesions on the face, trunk and limbs alongside vesiculobullous lesions on all 4 extremities.

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Bullous pemphigoid (BP) can be associated with various comorbidities, such as neurological disorders, hypertension, or diabetes. 1 Organspecific or non-organ-specific autoimmune comorbidities have also been reported. 2 They may have implication during the management of the patient. We report the fortuitous discovery of autoimmune atrophic chronic gastritis during the management of BP by methotrexate (MTX). To date, atrophic gastritis/pernicious anemia (PA) has been reported on two previous occasion. 3,4 An otherwise healthy 72-year-old man was diagnosed with typical BP that evolved for a month. He had generalized tense blisters