Association of bullous pemphigoid and comorbid health conditions: a case–control study

• Published in: Archives of Dermatological Research 2021-07, Vol.313 (5), p.327-332
• Main Authors: Lee, Sherry, Rastogi, Supriya, Hsu, Derek Y., Nardone, Beatrice, Silverberg, Jonathan I.
• Format: Article
• Language: English
• Subjects: Apnea; Autoimmune diseases; Basal cell carcinoma; Bullous pemphigoid; Comorbidity; Dermatology; Dermis; Diabetes mellitus; End-stage renal disease; Epidemiology; Epidermis; Hypertension; Kidney diseases; Medicine; Medicine & Public Health; Morbidity; Original Paper; Patients; Skin diseases; Sleep apnea; Sleep disorders
• ISSN: 0340-3696; 1432-069X
• DOI: 10.1007/s00403-020-02100-2

Background Bullous pemphigoid is an autoimmune skin disease characterized by the formation of blisters between the epidermis and dermis. Comorbidities of pemphigoid have not been well-described. Identification of comorbidities associated with pemphigoid is important to decrease morbidity and mortality. Objective To identify the comorbid health conditions of bullous pemphigoid. Methods This was a case–control study of 91 cases of pemphigoid verified by clinical and laboratory diagnosis and 546 age- and sex-matched controls with complete follow-up at a large metropolitan quaternary care medical center. Results The average age of bullous pemphigoid patients was 76 years and 53% of patients were female. Forty-eight (53%) of the BP patients had a history of inpatient hospitalization, of which 22 (24.2%) were hospitalized for either previously undiagnosed BP or an exacerbation of BP. Bullous pemphigoid was significantly associated with hypertension [adjusted odds ratio (95% confidence interval)]: [2.03 (1.24–3.32)], diabetes mellitus [2.59 (1.60–4.19)], chronic kidney disease [2.29 (1.19–4.40)], end-stage renal disease [3.82 (1.48–9.85)], basal cell carcinoma of the skin [6.00 (1.94–18.6)], and obstructive sleep apnea [5.23 (2.45–11.19)]. 78% of BP patients used at least one systemic immunosuppressant. There was no significant association between treatments for pemphigoid and any of the comorbidities. Conclusions Bullous pemphigoid patients need screening for comorbid health conditions even though treatment options do not seem to be associated with these comorbidities.