Association Between Bullous Pemphigoid and Neurologic Diseases: A Case-Control Study

Casas-de-la-Asunción, E.; Ruano-Ruiz, Juan; Rodríguez-Martín, A.M.; García-Nieto, Antonio Vélez; Moreno‐Giménez, J.C.

doi:10.1016/j.adengl.2014.09.010

Cited by 28 publications

(29 citation statements)

References 21 publications

(9 reference statements)

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“…In the present study, we found an increased prevalence of PD, AD and stroke among patients diagnosed with BP. This is consistent with previously reported results . During follow‐up, the risks of developing PD, AD or stroke were comparable with the risks in the background population.…”

Section: Discussionsupporting

confidence: 92%

“…Autoantibodies that bind to anchoring filaments of lowerlayer epidermal keratinocytes (target antigens BPAg1 and BPAg2) are essential to the pathogenesis of BP. Cross-reactions against BPAg1 isotopes in neurological tissues are hypothesized to link BP to neurological disorders such as multiple sclerosis (MS), 2,7,8 Parkinson disease (PD) 2,[9][10][11] and dementia. 2,[9][10][11][12] Other aspects of BP pathogenesis remain to be revealed.…”

Section: What Does This Study Add?mentioning

confidence: 99%

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Increased frequency of multiple sclerosis among patients with bullous pemphigoid: a population-based cohort study on comorbidities anchored around the diagnosis of bullous pemphigoid

Kibsgaard

Rasmussen

Lamberg³

et al. 2017

Br J Dermatol

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Section: Discussionsupporting

confidence: 92%

Section: What Does This Study Add?mentioning

confidence: 99%

Increased frequency of multiple sclerosis among patients with bullous pemphigoid: a population-based cohort study on comorbidities anchored around the diagnosis of bullous pemphigoid

Kibsgaard

Rasmussen

Lamberg³

et al. 2017

Br J Dermatol

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“…27 Being the first and only population-based study to investigate the association between BP and ND, it was less prone to selection and ascertainment bias than the aforementioned studies, with cases and controls being selected through a national healthcare database and matched by age, sex and general practice. 28,29 However, these studies were not statistically significant due to their smaller sample sizes. 20 Bastuji-Garin et al from France further confirmed these findings with the first prospective case-control study investigating possible risk factors for BP.…”

Section: Bullous Pemphigoidmentioning

confidence: 86%

A review of case–control studies on the risk factors for the development of autoimmune blistering diseases

Zhao

Murrell

2015

Acad Dermatol Venereol

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Autoimmune blistering diseases (AIBD) are a group of rare but potentially fatal diseases characterized by the production of autoantibodies directed against the structural proteins of the skin. Much has been published on the clinical manifestation and interventional options for AIBD, especially on the more common subtypes such as bullous pemphigoid, pemphigus vulgaris (PV) and pemphigus foliaceus (PF). However, the aetiology of AIBD remains unknown. We aim to provide an overview of published case-control studies focussing on the non-genetic aetiological factors of bullous pemphigoid, PV and/or PF. The relevant studies were appraised for their validity and results. Our results showed that a large proportion of the studies had inconclusive results due to compromised study methodologies. Moreover, there were no identified case-control studies that investigated the possible associations between bullous pemphigoid and patient environment, or the potential links between pemphigus and drugs. Hence, a case-control study with a higher quality design addressing these shortcomings would contribute greatly to our knowledge of AIBD.

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“…Multiple previous studies have reported increased prevalence of neurological diseases, including stroke, dementia, PD, multiple sclerosis, and amyotrophic lateral sclerosis, among patients with BP. The prevalence of PD in 13 identified cohorts of patients with BP ranged from 2.2% to 17.9% . Four of 9 studies identified demonstrated a statistically significant association between BP and PD (odds ratio [OR], 2.16; 95% confidence interval [CI], 1.09–4.27) and PD (OR, 5.0; 95% CI, 1.57–15.94), whereas the 5 remaining studies did not find a statistically significant correlation .…”

Section: Methodsmentioning

confidence: 99%

The Skin and Parkinson's Disease: Review of Clinical, Diagnostic, and Therapeutic Issues

Škorvánek

Bhatia

2016

Movement Disord Clin Pract

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Background: Parkinson's disease (PD) and the skin are related in a number of ways, including clinical abnormalities of the disease itself and skin-related side effects of dopaminergic medication, pumps, and surgical therapies. Recent advances in understanding the role of a-synuclein suggest skin biopsies as a potential diagnostic or even a premotor marker of PD. Methods: The PubMed database was searched for publications up to October 2015, and the current evidence on skin-related issues in PD was comprehensively summarized. Results: The evidence was summarized on the prevalence, etiology, and management of seborrheic dermatitis, sweating dysfunctions, bullous pemphigoid, and malignant melanoma, as well as therapy-related skin disorders, especially those observed in amantadine, rotigotine, apomorphine, and levodopa/carbidopa intestinal gel therapies and deep-brain stimulation. Skin biopsies evaluating the presence of a-synuclein, the density and morphology of cutaneous nerves, and skin fibroblast functions also are discussed. Conclusions: Skin disorders are a common manifestation of PD. However, the exact pathophysiology and prevalence of these disorders are not well understood, and more systematic research is needed in this regard. Peripheral tissue biopsies as a diagnostic marker of PD are an exciting avenue in future PD research, although multiple caveats and pending issues need to be solved before they can be used in routine clinical practice.Parkinson's disease (PD) is a progressive neurodegenerative disease characterized by the presence of multiple motor and nonmotor symptoms. Skin disorders, such as seborrheic dermatitis (SD) and hyperhidrosis, are well recognized and frequent -but often overlooked-nonmotor symptoms of PD; they have been associated with PD for nearly a century, since the first reports of seborrheic facies in PD by Krestin.1 Given the interest in biomarkers that precede the motor features of PD, it is worth noting that skin affection may precede the onset of typical motor symptoms by years. 2 Other skin disorders, such as malignant melanoma and bullous pemphigoid (BP), are significantly more prevalent in PD patients compared with the general population. 3,4 Recent advances in the understanding of the role of a-synuclein (SNCA) in the pathophysiology of PD, its prion-like mechanism of spreading, and findings of typical Lewy body pathology in the peripheral nervous system, suggest skin biopsies as a potential diagnostic marker of PD. Unlike the peripheral melanins produced in skin melanocytes, neuromelanin is produced in specific populations of catecholaminergic neurons in the brain. It is believed that neuromelanin interacts with transition metals, especially iron, and mediates intracellular oxidative mechanisms. This function seems to be compromised in PD, thus rendering pigmented neurons vulnerable to oxidative damage. 5 The skin can be affected by antiparkinsonian medication as well. Specific drug-delivery methods, such as skin patches, subcutaneous application of apomorphine, l...

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Association Between Bullous Pemphigoid and Neurologic Diseases: A Case-Control Study

Cited by 28 publications

References 21 publications

Increased frequency of multiple sclerosis among patients with bullous pemphigoid: a population-based cohort study on comorbidities anchored around the diagnosis of bullous pemphigoid

Increased frequency of multiple sclerosis among patients with bullous pemphigoid: a population-based cohort study on comorbidities anchored around the diagnosis of bullous pemphigoid

A review of case–control studies on the risk factors for the development of autoimmune blistering diseases

The Skin and Parkinson's Disease: Review of Clinical, Diagnostic, and Therapeutic Issues

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