Bullous Pemphigoid and Scabies: Is There an Association?

BACKGROUND: Bullous Pemphigoid (BP) is an autoimmune subepithelial bullous disease. Several reports suggested an association between BP and scabies. OBJECTIVE: We aimed to evaluate whether an association between BP and scabies exists. METHODS: This is a retrospective matched case-control study. We retrospectively identified BP patients treated in our clinic between January 1, 2009, and December 31, 2016. Each patient was assigned to 3 control subjects (matched by age and sex) treated in our clinic, not due to BP. The study group was examined for a scabies diagnosis within the 3 years prior to BP diagnosis; the control group was examined for a scabies diagnosis 3 years prior to its first visit in our clinic. RESULTS: Fifteen out of the 87 (17.2%) BP patients were diagnosed with scabies within the 3 years prior to their initial BP diagnosis, compared to only 4.2% (11 out of 261) among the control group. The odds ratio of scabies history was 4 times higher among BP patients compared to the control group (OR=4.23; 95% CI: 1.50–11.91, P=0.007). LIMITATIONS: A retrospective study design. CONCLUSIONS: An association between scabies diagnosis and BP is demonstrated in our study. J Drugs Dermatol. 2022;21(9):1009-1011. doi:10.36849/JDD.4900.

Mortality and risk factors among Israeli bullous pemphigoid patients.

There are differences concerning reported mortality rates and prognostic factors of bullous pemphigoid (BP) patients in different studies. Our objectives were to evaluate the mortality rates and prognostic factors among Israeli BP patients compared to matched control subjects. Three age- and sex-matched patients without BP (n = 261) who were treated in our clinic were selected and compared to BP patients (n = 87). Mean survival period of the BP group was 4.1 years (95% CI: 3.3-4.8 years) and 5.9 years among the non-BP group (95% CI: 5.6-6.3 years). The 1-year mortality rate was 24.1% for the BP group and 6.5% for the control group. In multivariate analysis, age above 80 was a significant risk factor for mortality [HR 3.22 (95% CI, 1.15-8.96), p = 0.03], while statins intake had a protective role [HR 0.36 (95% CI, 0.15-0.88), p = 0.03]. In univariant analysis, dementia [HR 2.44 (95% CI, 1.02-5.99), p = 0.04] was a risk factor. In conclusion, BP patients' mortality is correlated to increasing age at diagnosis, dementia, and statins use. Statins' protective role is newly discussed in the literature.