Index > Vol. 85/2005 > Iss. 2/March > pp. 136-139 > Abstract
Letter to the Editor

A Retrospective Epidemiological Study on the Association of Bullous Pemphigoid and Neurological Diseases

doi: 10.1080/00015550410024481

Abstract:

Bullous pemphigoid is a rare chronic recurrent Dermatosis that is often reported in association with various neurological diseases. No investigation involving a large number of patients has ever been carried out to demonstrate such an association. This study was accomplished by analysing the discharge diagnosis of all hospitalized patients, both day-patients and inpatients, during a 5-year period (1995-2000) covering a total population group of 934,023 living in a region of Italy that has approximately 1,200,000 inhabitants. The results support the hypothesis of an association between bullous pemphigoid, multiple sclerosis and Parkinson's disease on a highly significant statistical basis. The aetiopathogenic mechanisms and the causes that induce the loss of immunological tolerance are not yet understood.

References:

  1. Robledo, M. A, Kim, S. C, Korman, N. J, Stanley, J. R, Labib, R. S, Futamura, S, et al, . Studies of the relationship of the 230 kD and 180 kD bullous pemphigoid antigens. J Invest Dermatol, 1990; 94: 793-797
  2. Zhu, X, Niimi, Y, Bystryn, J. C. Identification of 160 kD molecule as a component of the basement membrane zone and as a minor bullous pemphigoid antigen. J Invest Dermatol, 1990; 94: 817-821
  3. Tanaka, T, Korman, N. J, Shimizu, H, Eady, R. A, Klaus-Kovtun, V, Cehrs, K, et al, . Production of rabbit antibodies against carboxy-terminal epitopes encoded by bullous pemphigoid cDNA. J Invest Dermatol, 1990; 94: 617-623
  4. Sawamura, D, LiK, , Chu, M, Uitto, J. Human bullous antigen (BPAG1). Amino acid sequences deduced from cloned cDNAs predict biologically important peptide segments and protein domains. J Biol Chem, 1991; 266: 17784-17790
  5. Tamai, K, Silos, S. A, Li, K, Korkeela, E, Ishikawa, H, Uitto, J. Tissue specific expression of the 230-Kda bullous pemphigoid antigen (BPAG). Identification of a novel keratinocyte regulatory cis-element KRE3. J Biol Chem, 1995; 270: 7609-7614
  6. Jung, M, Kippes, W, Messer, G, Zilinkens, D, Rzany, B. Increased risk of bullous pemphigoid in male and very old patients: a population-based study on incidence. J Am Acad Dermatol, 1999; 41: 266-268
  7. Simjee, S, Konqui, A, Razzaque, A. Multiple sclerosis and bullous pemphigoid. Dermatologica, 1985; 170: 86-89
  8. Masouyé, I, Schmied, E, Didierjean, L, Abba, Z, Saurat, J. H. Bullous pemphigoid and multiple sclerosis: more than a coincidence? J Am Acad Dermatol, 1989; 21: 63-68
  9. Gebauer, K, Cox, J, Gartside, J, Navaratnam, T. Bullous pemphigoid and multiple sclerosis. J Am Acad Dermatol, 1990; 23: 329
  10. Machet, L, Vailiant, L, de Muret, A, Clavere, A, Lorette, G. Pemphigoide bulleuse et sclérose en plaques. A propos d'un cas. Ann Dermatol Venereol, 1991; 118: 47
  11. Saada, V, Janssen, F, Vignon-Pennamen, M. O, Flageul, B, Cottenot, F. Association pemphigoïde bulleuse-sclérose en plaques. A propos d'un cas. Ann Dermatol Venereol, 1990; 117: 459-461
  12. Trozak, D. J. Bullous pemphigoid and multiple sclerosis. J Am Acad Dermatol, 1990; 22: 860
  13. Doutre, M. S, Beylot, C, Delage, F, Hans, P. Pemphigoide bulleuse et sclérose en plaques. Une nouvelle observation. Ann Dermatol Venereol, 1991; 118: 49
  14. Tomasini, D, Bonfacini, V, Martin-Ortega, E, Puig, S, Vicente, A, Herrero, C, et al, . Pemphigoide bulleuse et sclérose en plaques. Ann Dermatol Venereol, 1991; 118: 474-475
  15. Tohme, A, Mattar, L, Zebouni, A, Koussa, S. Pemphigoide bulleuse et sclérose en plaques. Ann Dermatol Venereol, 1994; 121: 139-142
  16. Kirtschig, G, Walkden, V. M, Venning, V. A, Wojnarowska, F. Bullous pemphigoid and multiple sclerosis: a report of three cases and review of the literature. Clin Exp Dermatol, 1995; 20: 449-453
  17. Downs, A, Lear, J. T, Bower, C. P, Kennedy, C. T. Does influenza vaccination induce bullous pemphigoid? A report of four cases. Br J Dermatol, 1998; 138: 363
  18. Foureur, N, Descamps, V, Lebrun-Vignes, B, Picard-Dahan, C, Grossin, M, Belaich, S, et al, . Bullous pemphigoid in a leg affected with hemiparesia: a possible relation of neurological diseases with bullous pemphigoid? Eur J Dermatol, 2001; 11: 230-233
  19. Forschner, A, Ulmer, A, Rassner, G, Fierlbeck, G. Bullous pemphigoid in a patient with Parkinson's disease. Eur J Dermatol, 2002; 12: 615
  20. Stinco, G, Mattighelo, P, Zanchi, M, Patrone, P. Multiple sclerosis and bullous pemphigoid: a casual association or a pathogenetic correlation? Eur J Dermatol, 2002; 12: 186-188
  21. Vaillant, L, Bernard, P, Joly, P, Prost, C, Labeille, B, Bedane, C, et al, . Evaluation of clinical criteria for diagnosis of bullous pemphigoid. Arch Dermatol, 1998; 134: 1075-1080
  22. Brown, A, Bernier, G, Mathieu, M, Rossant, J, Kothary, R. The mouse dystonia musculorum gene is a neural isoform of bullous pemphigoid antigen 1. Nat Genet, 1995; 10: 301-306
  23. Nesbit, G. M, Forbes, G. S, Scheithauer, B. W, Okazaki, H, Rodriguez, M. Multiple sclerosis: histopathologic and MR and/or CT in 37 cases at biopsy and three cases at autopsy. Radiology, 1991; 180: 467-474
  24. Barnes, D, Munro, P. M, Youl, B. D, Prineas, J. W, McDonald, W. I. The longstanding MS lesion. A quantitative MRI and electron microscopic study. Brain, 1991; 114: 1271-1280
  25. Kermode, A. G, Tofts, P. S, Thompson, A. J, MacManus, D. G, Rudge, P, Kendall, B. E, et al, . Heterogeneity of blood-brain barrier changes in multiple sclerosis: an MRI study with gadolinium-DTPA enhancement. Neurology, 1990; 40: 229-235