Comorbid diseases in bullous pemphigoid: A population-based case-control study.

Area of Science:

• Dermatology
• Autoimmune Disorders
• Epidemiology

Background:

• Bullous pemphigoid (BP) is a prevalent autoimmune blistering disease targeting hemidesmosomes.
• BP is linked to significant morbidity and mortality.
• Comprehensive evaluation of comorbidities before and after BP diagnosis is lacking.

Purpose of the Study:

• To investigate all comorbid diseases associated with bullous pemphigoid.
• To analyze patterns of comorbidity associations in BP patients.
• To identify predisposing and prognostic factors in BP.

Main Methods:

• Nationwide population-based case-control study (2011-2021).
• Included 5066 BP patients and 10,132 controls.
• Automated mass screening of 546 diagnostic codes for comorbidities 5 years pre- and post-BP diagnosis.

Main Results:

• BP patients had higher odds of pressure ulcers, intracerebral hemorrhage, scabies, neuropsychiatric disorders, psoriasis, drug eruption, and acute renal failure before diagnosis.
• Post-BP diagnosis, increased odds of pneumonia, sepsis, chronic renal disease, and cardiac arrest were observed.
• Strong interrelationships among neuropsychiatric conditions pre-BP and bidirectional association between Alzheimer's dementia and pneumonia post-BP were noted.

Conclusions:

• This study comprehensively identified comorbidities associated with BP before and after diagnosis.
• Identified comorbidities hold significant clinical importance.
• Comorbidities serve as potential predisposing and prognostic factors in BP management.