University of Oulu

Outi Varpuluoma, Jari Jokelainen, Anna-Kaisa Försti, Markku Timonen, Laura Huilaja, Kaisa Tasanen, Dermatitis Herpetiformis and Celiac Disease Increase the Risk of Bullous Pemphigoid, Journal of Investigative Dermatology, Volume 139, Issue 3, 2019, Pages 600-604, ISSN 0022-202X,

Dermatitis herpetiformis and celiac disease increase the risk of bullous pemphigoid

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Author: Varpuluoma, Outi1,2; Jokelainen, Jari3,4; Försti, Anna-Kaisa1,2;
Organizations: 1PEDEGO Research Unit, University of Oulu, Oulu, Finland
2Department of Dermatology and Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
3Unit of General Practice, Oulu University Hospital, Oulu, Finland
4Center for Life Course Epidemiology and Systems Medicine, University of Oulu, Oulu, Finland
Format: article
Version: accepted version
Access: open
Online Access: PDF Full Text (PDF, 0.4 MB)
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Language: English
Published: Elsevier, 2019
Publish Date: 2019-10-26


Bullous pemphigoid (BP) and dermatitis herpetiformis (DH) are autoimmune bullous skin diseases. DH has been described to evolve into BP and the two diseases can have overlapping clinical appearances and diagnostic findings, but the association between DH and BP has not previously been studied in a large population. To evaluate DH and celiac disease as risk factors for BP, we conducted a retrospective case-control study of patients with BP and matched controls with basal cell carcinoma diagnosed in Finland between 1997 and 2013. A total of 3,397 patients with BP and 12,941 controls were included in the study. Forty-one (1.2%) BP patients and 7 (0.1%) controls had preceding DH. Diagnosed DH increased the risk of BP 22-fold (odds ratio = 22.30; 95% confidence interval = 9.99–49.70) and celiac disease 2-fold (odds ratio = 2.54; 95% confidence interval = 1.64–3.92) compared to controls. Eighteen (43.9%) of the patients who had DH and subsequent BP had bought dapsone during the 2 years prior to their BP diagnosis. Mean time between diagnosed DH and BP was 3 years. We conclude that diagnosis of DH is associated with a striking increase in the risk for BP.

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Series: Journal of investigative dermatology
ISSN: 0022-202X
ISSN-E: 1523-1747
ISSN-L: 0022-202X
Volume: 139
Issue: 3
Pages: 600 - 604
DOI: 10.1016/j.jid.2018.10.010
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Copyright information: © 2018 The Authors. Published by Elsevier, Inc. This manuscript version is made available under the CC-BY-NC-ND 4.0 license