The Intriguing Links between Psoriasis and Bullous Pemphigoid

Area of Science:

• Dermatology
• Immunology
• Autoimmune Diseases

Background:

• Psoriasis and autoimmune bullous diseases (AIBDs), especially bullous pemphigoid (BP), can coexist.
• Psoriasis onset typically precedes BP onset in these patients.
• Concomitant BP and psoriasis cases often present with younger onset and fewer lesions than isolated BP.

Purpose of the Study:

• To review the association between psoriasis and bullous pemphigoid.
• To examine epidemiological, clinical, and immunopathological aspects.
• To explore pathomechanisms, potential triggers, and management strategies.

Main Methods:

• Literature review of case reports, series, and epidemiological studies.
• Analysis of clinical presentations and immunopathological findings.
• Discussion of proposed pathomechanisms, including epitope spreading.

Main Results:

• The majority of patients with coexisting psoriasis and BP show psoriasis onset first.
• Patients with both conditions are generally younger at BP onset and exhibit milder blistering.
• Anti-laminin gamma-1 pemphigoid is considered a potential mimic of BP in some psoriasis patients.

Conclusions:

• The association between psoriasis and BP may represent a distinct clinical entity or a specific subtype of AIBD.
• Epitope spreading is a leading hypothesis for the pathomechanism.
• Further research is needed to elucidate the exact pathomechanisms and optimize treatment.