Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel.
Arch Dermatol Res. 2022 Jan;314(1):77-83. doi: 10.1007/s00403-021-02211-4. Epub 2021 Mar 9.
The association between bullous pemphigoid (BP) and melanoma is yet to be investigated. We aimed to assess assess the bidirectional association between BP and melanoma and to delineate the epidemiological features of patients with both diagnoses. A population-based cohort study was performed comparing BP patients (n = 3924) with age-, sex- and ethnicity-matched control subjects (n = 19,280) with regard to incident cases of melanoma. A case-control design was additionally adopted to estimate the risk of BP in individuals with a preexisting diagnosis of melanoma. The prevalence of preexisting melanoma was higher in patients with BP than in control subjects (1.5% vs. 1.0%, respectively; P = 0.004). A history of melanoma confers a 50% increase in the risk of subsequent BP (OR 1.53; 95% CI 1.14-2.06). This risk was higher among males (OR 1.66; 95% CI 1.09-2.54) and individuals older than 80 years (OR 1.63; 95% CI 1.11-2.38), and persisted after adjustment for multiple putative confounders including PD-1/PDL-1 antagonists (adjusted OR 1.53; 95% CI 1.14-2.06). Conversely, the risk of melanoma among patients with BP was slightly elevated, but did not reach the level of statistical significance (adjusted HR 1.13; 95% CI 0.73-1.74). Patients with a dual diagnosis of BP and melanoma were older at the onset of BP and had lower body mass index. A history of melanoma is associated with a 50% increase in the incidence of subsequent BP. Physicians managing patients with both conditions should be aware of this association. Further research is warranted to reveal the underlying mechanism of these findings.
大疱性类天疱疮（BP）与黑色素瘤之间的关联尚未得到研究。我们旨在评估 BP 和黑色素瘤之间的双向关联，并描绘出同时患有这两种疾病的患者的流行病学特征。我们进行了一项基于人群的队列研究，比较了 BP 患者（n=3924）与年龄、性别和种族匹配的对照受试者（n=19280）中黑色素瘤的发病情况。此外，还采用病例对照设计来估计先前诊断为黑色素瘤的个体患 BP 的风险。与对照受试者相比，BP 患者中先前存在黑色素瘤的比例更高（分别为 1.5%和 1.0%；P=0.004）。先前患有黑色素瘤会使随后发生 BP 的风险增加 50%（OR 1.53；95%CI 1.14-2.06）。这种风险在男性（OR 1.66；95%CI 1.09-2.54）和 80 岁以上的个体中更高（OR 1.63；95%CI 1.11-2.38），并且在调整了包括 PD-1/PDL-1 拮抗剂在内的多个潜在混杂因素后仍然存在（调整后的 OR 1.53；95%CI 1.14-2.06）。相反，BP 患者中黑色素瘤的风险略有升高，但未达到统计学意义（调整后的 HR 1.13；95%CI 0.73-1.74）。同时患有 BP 和黑色素瘤的患者在 BP 发病时年龄更大，体重指数更低。先前患有黑色素瘤与随后发生 BP 的风险增加 50%相关。管理同时患有这两种疾病的患者的医生应注意到这种关联。需要进一步的研究来揭示这些发现的潜在机制。
