Neurological and Psychiatric Comorbidities in Bullous Pemphigoid

 

Elena Mirceska Arsovska¹, Katerina Damevska¹, Viktor Simeonovski¹, Andrija Jović², Danica Tiodorović^{2, 3}

 

¹University Clinic for Dermatology, Faculty of Medicine, University Ss. Cyril and Methodius in Skopje,
Skopje, Republic of North Macedonia
²Clinic of Dermatovenereology, University Clinical Center Niš, Serbia
³University of Niš, Faculty of Medicine, Niš, Serbia

 

SUMMARY

  

Introduction: Bullous pemphigoid (BP) is an autoimmune skin disease that typically presents with severe itching and blistering, with or without eczematous and urticarial lesions. Patients with BP are at an increased risk of comorbid conditions, especially neurologic and psychiatric diseases. Several recent studies have found a link between BP and neurological disorders, especially stroke, dementia, and Parkinson's disease. The aim of our study was to evaluate the prevalence of neurological and psychiatric comorbidities and their treatment in BP patients.
Methods: A cross-sectional, observational, descriptive study was conducted based on the analysis of the medical records of 105 patients with confirmed BP. Demographic and clinical data on BP, neurological and psychiatric comorbidities were collected and statistically analyzed for all patients.
Results: The median age was 77.8±10.6 years (range, 39-98 years). Among the study group, 71 (67,61%) patients had neurological comorbidity. Comorbidity with the highest frequency was ischemic stroke found in 28 (26,67%) patients, followed by dementia in 27 (25,71%), Alzheimer’s in 11 (10,48%) and Parkinson’s disease 5 (4,76%) patients. It was noted that there was a statistically significant difference among male and female patients with Alzheimer's disease (p = 0,0046) and psychiatric disorder (p = 0,044).
Conclusion: Neurological disorders usually precede the diagnosis of BP, and mortality may be higher in patients with comorbid conditions. Clinicians should be aware of the early signs and symptoms of BP, primarily in patients with primary neurological disorders such as dementia, stroke, or Parkinson's disease.

 Keywords: pemphigoid, bullous, nervous system diseases, ischemic stroke, mental disorders

 

Corresponding author:

Elena Mirceska Arsovska

e-mail: elenamirceska@yahoo.co.uk