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

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Abstract

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.

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Abbreviations

ICD-9-CM:

International Classification of Disease 9th edition Clinical Modification

BP:

Bullous pemphigoid

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Funding

This publication was made possible with support from the Agency for Healthcare Research and Quality (AHRQ) K12 HS023011 the Dermatology Foundation.

Design and conduct of the study? No.

Collection, management, analysis and interpretation of data? No.

Preparation, review, or approval of the manuscript? No.

Decision to submit the manuscript for publication? No.

Author information

Authors and Affiliations

  1. Department of Dermatology, Northwestern University Feinberg School of Medicine, Suite 1600, 676 N Saint Clair Street, Chicago, IL, 60611, USA

    Sherry Lee, Supriya Rastogi, Derek Y. Hsu, Beatrice Nardone & Jonathan I. Silverberg

  2. Department of Dermatology, George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue NW, Washington, DC, 20037, USA

    Jonathan I. Silverberg

Authors
  1. Sherry Lee
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  2. Supriya Rastogi
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  3. Derek Y. Hsu
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  4. Beatrice Nardone
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  5. Jonathan I. Silverberg
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Contributions

JIS had full access to all the data in the study and takes responsibility for the integrity of the data and accuracy of the data analysis. Study concept and design: JIS. Acquisition of Data: SL, SR, DYH, BN, JIS. Analysis and interpretation of data: SL, SR, DYH, BN, JIS. Drafting of the manuscript: SL, SR, JIS. Critical revision of the manuscript for important intellectual content: SL, SR, DYH, BN, JIS. Statistical analysis: SL, JIS. Obtained funding: JIS.

Corresponding author

Correspondence to Jonathan I. Silverberg.

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The authors declared that they have no conflict of interest.

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Lee, S., Rastogi, S., Hsu, D.Y. et al. Association of bullous pemphigoid and comorbid health conditions: a case–control study. Arch Dermatol Res 313, 327–332 (2021). https://doi.org/10.1007/s00403-020-02100-2

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  • DOI: https://doi.org/10.1007/s00403-020-02100-2

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