A population-based study of the association between bullous pemphigoid and neurologic disorders

J Am Acad Dermatol. 2014 Aug 29. pii: S0190-9622(14)01783-6. doi: 10.1016/j.jaad.2014.07.052. [Epub ahead of print]

Brick KE, Weaver CH, Savica R, Lohse CM, Pittelkow MR, Boeve BF, Gibson LE, Camilleri MJ, Wieland CN.

BACKGROUND:

Bullous pemphigoid (BP) has been associated with neurologic disorders.

OBJECTIVE:

We sought to analyze the association between BP and neurologic disorders.

METHODS:

We retrospectively identified residents of Olmsted County, Minnesota, with a first lifetime diagnosis of BP between January 1, 1960, and December 31, 2009. Three age- and sex-matched Olmsted County, Minnesota, residents without BP were selected as control subjects for each patient. We compared history of or development of neurologic disorders (dementia, Alzheimer disease, Parkinson disease, multiple sclerosis, cerebrovascular disease, and seizures) between groups using case-control and cohort designs.

RESULTS:

In all, 87 patients with BP were identified and matched to 261 control subjects. The odds of a previous diagnosis of any neurologic disorder or a history of dementia were significantly increased among cases compared with controls (odds ratio 6.85; 95% confidence interval [CI] 3.00-15.64; P < .001; and odds ratio 6.75; 95% CI 2.08-21.92; P = .002, respectively). Both Parkinson disease (hazard ratio 8.56; 95% CI 1.55-47.25; P = .01) and any type of neurologic disorder (hazard ratio 2.02; 95% CI 1.17-3.49; P = .01) were significantly more likely to develop during follow-up in patients with than without BP.

LIMITATIONS:

Small geographic area and retrospective study design are limitations.

CONCLUSION:

Findings confirmed an association of BP with neurologic disorders, especially dementia and Parkinson disease.