患有大疱性类天疱疮和合并银屑病的患者水疱较少，血清中抗 BP180 自身抗体水平较低。

Patients with bullous pemphigoid and comorbid psoriasis present with less blisters and lower serum levels of anti-BP180 autoantibodies.

机构信息

Department of Dermatology, University of Lübeck, Lübeck, Germany.

Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.

出版信息

J Eur Acad Dermatol Venereol. 2021 Apr;35(4):981-987. doi: 10.1111/jdv.17013. Epub 2020 Nov 17.

DOI:10.1111/jdv.17013

PMID:33098720

Abstract

BACKGROUND

Although the association of bullous pemphigoid (BP) and psoriasis is well-established, the clinical and immunological features of patients with coexisting BP and psoriasis are yet to be investigated.

OBJECTIVE

We aimed to estimate the prevalence of psoriasis amongst patients with BP and to elucidate the clinical and immunological characteristics of BP patients with comorbid psoriasis.

METHODS

A retrospective cohort study including all consecutive patients diagnosed with BP throughout the years 2009-2019 in a tertiary referral centre.

RESULTS

The study encompassed 273 patients with BP, of whom 11 (4.0%; 95% CI, 2.3-7.1%) had comorbid psoriasis. The onset of psoriasis preceded that of BP in 81.8% of patients by a median (range) latency of 26.5 (5.0-34.0) years. Compared to BP patients without psoriasis, those with BP and comorbid psoriasis were significantly younger at the onset of BP [71.8 (9.3) vs. 79.4 (9.8) years; P = 0.023], had a milder erosive phenotype [erosion/blister BPDAI mean (SD)score; 5 (4.1) vs. 22.3 (15.2); P = 0.025], lower levels of anti-BP180 NC16A serum autoantibodies [236.6 (266.3) vs. 556.2 (1323.6) U/mL; P = 0.008] and a higher prevalence of isolated linear C3 deposits (36.4% vs. 14.1%; P = 0.043) and a lower prevalence of linear immunoglobulin G deposits (36.4% vs. 68.7%; P = 0.025) along the dermal-epidermal junction by direct immunofluorescence microscopy.

CONCLUSIONS

Patients with BP and comorbid psoriasis present at a younger age with milder erosive phenotype and lower levels of pathogenic autoantibodies.

摘要

背景

尽管天疱疮（BP）与银屑病之间存在关联已得到充分证实，但同时患有 BP 和银屑病患者的临床和免疫学特征仍有待研究。

目的

我们旨在评估 BP 患者中银屑病的患病率，并阐明同时患有 BP 和银屑病的 BP 患者的临床和免疫学特征。

方法

这是一项回顾性队列研究，纳入了 2009 年至 2019 年期间在一家三级转诊中心确诊的所有连续 BP 患者。

结果

该研究共纳入了 273 例 BP 患者，其中 11 例（4.0%；95%CI，2.3-7.1%）合并银屑病。银屑病的发病先于 BP，中位（范围）潜伏期为 26.5（5.0-34.0）年。与无银屑病的 BP 患者相比，同时患有 BP 和银屑病的患者 BP 的发病年龄明显更小[71.8（9.3）岁比 79.4（9.8）岁；P=0.023]，且具有更轻微的侵蚀性表型[侵蚀/水疱 BPDAI 平均（SD）评分；5（4.1）分比 22.3（15.2）分；P=0.025]，抗 BP180 NC16A 血清自身抗体水平更低[236.6（266.3）U/mL 比 556.2（1323.6）U/mL；P=0.008]，且沿表皮-真皮交界处直接免疫荧光显微镜下存在线性 C3 沉积的比例更高（36.4%比 14.1%；P=0.043），而线性免疫球蛋白 G 沉积的比例更低（36.4%比 68.7%；P=0.025）。