Bullous pemphigoid linked to cerebrovascular disease and dementia
MedWire News: Findings from two studies suggest that patients with the autoimmune skin condition bullous pemphigoid (BP) have an increased risk for developing cerebrovascular disease and dementia compared with the general population.
In the first study, published in the Archives of Dermatology, Kathy Taghipour (Oxford University, UK) and colleagues assessed 90 patients with BP and 141 without (controls) from Oxford in the UK to evaluate prevalence of neurologic disorders. The median age at BP onset was 80 years.
Overall, 46% of BP patients versus 11% of controls had at least one neurologic diagnosis. These included cerebrovascular disease, dementia, Parkinson's disease, and epilepsy, the risk for which increased by a significant 6.3-, 6.0-, 10.7-, and 7.9-fold, respectively, in patients with BP versus controls.
The second study, carried out by Sinéad Langan (King's College London, UK) and co-workers, included 868 BP patients and 3453 controls with a similar age at onset of BP as in the previous study. Data was obtained from the Health Improvement Network, a large UK general practice database.
Writing in the Journal of Investigative Dermatology, Langan and team report that the relative risk for stroke, dementia, Parkinson's disease, epilepsy, and multiple sclerosis was increased 1.8-, 3.4-, 3.0-, 1.7-, and 10.7-fold, respectively, in BP patients compared with controls.
The associations were only significant where neurological disease was diagnosed before the onset of BP, note Langan and colleagues.
"Neurologic symptoms may often be subtle, and the onset of disease may be insidious, leading to diagnostic delay," write Taghipour et al.
"It is therefore likely that the interval between neurologic disease and BP is longer than estimated, and it is tempting to speculate that certain neurologic conditions can predispose to bullous pemphigoid."
Langan et alconclude: "These findings are coherent with the results of previous case-control studies and case reports from many different geographical regions, which report strong associations between previous neurological diseases and the later development of BP."
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By Helen Albert