MedWire News: Having a neurological or psychiatric disorder, being bedridden, or being a chronic user of various drugs significantly increases the risk for bullous pemphigoid (BP) in elderly individuals, say researchers.

"A rise in the incidence of BP was documented recently in Europe, and the main risk factors for BP remain unknown," write Sylvie Bastuji-Garin (Université Paris-Est, Créteil, France) and co-workers. This condition is also much more common in people over the age of 60 years than in younger individuals.

To investigate possible reasons for this, the team selected 201 individuals (64.7% female), aged 84.2 years on average, with incident BP and 345 controls who were matched for gender, age, place of residence, and center.

Diagnosis of BP was based on identification of typical clinical features and on direct immunofluorescence showing linear deposits of immunoglobulin G and/or C3 along the basement membrane zone.

Drug use over 3 months, comorbidities, and physical and cognitive impairments were compared between cases and controls.

As reported in the Journal of Investigative Dermatology, multivariate analysis showed that major cognitive impairment, being bedridden, having Parkinson's disease or unipolar/bipolar disorder, or chronic use of spironolactone or phenothiazines with aliphatic side chains increased the risk for BP a significant 2.19-, 2.19-, 2.16-, 5.25-, 2.30, and 3.70-fold, respectively.

In contrast, chronic use of analgesics reduced the relative risk for BP by a significant 51%.

"These findings may have implications for the management of BP patients," write the authors.

"Moreover, they indicate a need for further investigations into the association of BP with neurological disorders," they conclude.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Free abstract