The Bidirectional Association Between Bullous Pemphigoid and Psoriasis: A Population-Based Cohort Study

Kridin, Khalaf; Ludwig, Ralf J.; Schonmann, Yochai; Damiani, Giovanni; Cohen, Arnon D

doi:10.3389/fmed.2020.00511

Cited by 26 publications

(37 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Prominent neutrophilic infiltrate was recently found to unduly the association of BP with comorbid psoriasis. 43,44 Although neutrophils emerged as a key player in the pathogenesis of BP in experimental murine models, 45 their role in human BP is less established as neutrophilpredominant infiltration is rarely encountered in lesional skin of BP patients. A recent study in a humanized IgE receptor mouse model depicted that eosinophils, independent of neutrophils, were required for inducing blister formation by anti-human BP180 NC16A IgE.…”

Section: Discussionmentioning

confidence: 99%

“…Different from a recent case‐series reporting two cases of neutrophil‐predominant BP arising after the administration of programmed death (PD)‐1 antagonists, 42 none of our two patients with PD‐1‐associated BP had a neutrophilic‐predominant infiltration. Prominent neutrophilic infiltrate was recently found to unduly the association of BP with comorbid psoriasis 43,44 . Although neutrophils emerged as a key player in the pathogenesis of BP in experimental murine models, 45 their role in human BP is less established as neutrophil‐predominant infiltration is rarely encountered in lesional skin of BP patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid

Ständer

Hammers

Vorobyev

et al. 2021

Acad Dermatol Venereol

View full text Add to dashboard Cite

Background The influence of cutaneous cellular infiltration on the phenotype of bullous pemphigoid (BP) remains to be established.Objectives To evaluate the main histopathological characteristics of patients with BP and to assess the association between the composition of lesional inflammatory infiltrate and the various clinical, immunological and immunopathological aspects of the disease. MethodsRetrospective study encompassing patients diagnosed with BP throughout the years 2009-2020 in a specialized tertiary referral centre. ResultsThe study encompassed 136 patients with BP, of whom 27 (19.9%) demonstrated a cell-poor inflammatory infiltrate in lesional skin specimens. Overall, 78 (57.4%), 71 (52.2%) and 5 (3.7%) specimens were found to include eosinophil-predominant, lymphocyte-predominant and neutrophil-predominant inflammatory infiltrates, respectively.Relative to the remaining patients with BP, those with an eosinophil-predominant inflammatory infiltrate had higher (90.8% vs. 77.2%; P = 0.030) whilst those with a cell-poor inflammatory infiltrate lower (70.3% vs. 88.7%; P = 0.017) seropositivity of anti-BP180 NC16A IgG. The latter subgroup presented with higher prevalence of mucosal involvement (25.9% vs. 8.3%; P = 0.011) and a non-inflammatory clinical phenotype (50.0% vs. 17.1%; P = 0.041). Patients with lymphocyte-predominant inflammatory infiltrate manifested with higher severity BPDAI scores and a lower frequency of the non-inflammatory subtype (11.1% vs. 36.4%; P = 0.035), whilst those with a neutrophilic infiltrate presented with lower mean (SD) levels of anti-BP180 NC16A IgG [269.3 (227.6) vs. 722.7 (1499.6) U/mL; P = 0.003].Conclusions Eosinophil-predominance and high cellularity in the lesional inflammatory infiltrate of BP skin are associated with increased seropositivity of anti-BP180 NC16A IgG. Lymphocyte-predominant infiltrates predict a more severe phenotype, pointing towards a pathogenic role of autoreactive lymphocytes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid

Ständer

Hammers

Vorobyev

et al. 2021

Acad Dermatol Venereol

View full text Add to dashboard Cite

show abstract

“…The last decades witnessed a considerable increase in the risk of the disease, which has been attributed, at least in part, to increased f longevity and exposure to several drugs [5]. The past few years yielded a prominent advance in elucidating the comorbidity profile of patients with BP owing to an increasing number of well-designed controlled observational studies [1,6].…”

Section: Introductionmentioning

confidence: 99%

Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

et al. 2021

Self Cite

View full text Add to dashboard Cite

The association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case–control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14–2.06). This risk was higher among males (OR 1.66; 95% CI 1.09–2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11–2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14–2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73–1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.

show abstract

“…Given the increased morbidity and mortality typifying the disease, 2,3 BP imposes a high health burden on healthcare systems worldwide 4,5 . The past few years bore substantial advances in delineating the comorbidity profile of patients with BP owing to a growing number of well‐designed controlled observational studies 1,6 . The association of BP with neurological diseases was among the most robust comorbidities uncovered in the past two decades 7 .…”

Section: Introductionmentioning

confidence: 99%

Coexistence of bullous pemphigoid with neuropsychiatric comorbidities is associated with anti‐BP230 seropositivity

Ständer

Hammers

Vorobyev

et al. 2021

Acad Dermatol Venereol

View full text Add to dashboard Cite

Background While clustering of bullous pemphigoid (BP) with neuropsychiatric diseases is well‐established, the clinical and immunological profile of BP patients with this comorbidity remains to be decisively determined. Objectives To evaluate the burden of neurological and psychiatric comorbidities among patients with BP and to elucidate the clinical, immunological and immunopathological features of patients with BP and comorbid neuropsychiatric conditions. Methods We performed a retrospective study encompassing patients diagnosed with BP throughout the years 2009–2020 in a specialized tertiary referral centre. Multivariate logistic regression model was used to identify predictors of neuropsychiatric conditions among patients with BP. Results The study included 273 patients with BP, of whom 123 (45.1%) presented with comorbid neuropsychiatric disease. Compared to the remaining patients with BP (n = 150), those with pre‐existing neuropsychiatric diseases demonstrated older mean [standard deviation (SD)] age [81.7 (9.1) vs. 76.9 (10.1); P < 0.001], female preponderance (65.0% vs. 49.3%; P = 0.009), higher seropositivity rate of anti‐BP230 (67.7% vs. 36.5%; P = 0.006) and higher levels of anti‐BP180 NC16A IgG [651.3 (1279.6) vs. 370.4 (818.6) U/mL; P = 0.039]. In multivariate analysis, anti‐BP230 seropositivity was independently associated with coexistence of BP with neuropsychiatric conditions [adjusted odds ratio (OR), 3.43; 95% CI, 1.24–9.52; P = 0.018]. In a sensitivity analysis confined to patients with neurological diseases (n = 103), older age [82.1 (8.4) vs. 77.2 (10.3); P < 0.001] and increased anti‐BP230 seropositivity (68.0% vs. 39.7%; P = 0.018) were identified. Conclusions The coexistence of BP with neuropsychiatric diseases is independently associated with the generation of anti‐BP230 antibodies.

show abstract

The Bidirectional Association Between Bullous Pemphigoid and Psoriasis: A Population-Based Cohort Study

Cited by 26 publications

References 30 publications

The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid

The impact of lesional inflammatory cellular infiltrate on the phenotype of bullous pemphigoid

Melanoma is associated with an increased risk of bullous pemphigoid: a large population-based longitudinal study

Coexistence of bullous pemphigoid with neuropsychiatric comorbidities is associated with anti‐BP230 seropositivity

Contact Info

Product

Resources

About