期刊
JOURNAL OF CLINICAL MEDICINE
卷 12, 期 1, 页码 -出版社
MDPI
DOI: 10.3390/jcm12010328
关键词
psoriasis; bullous pemphigoid
The coexistence of psoriasis with autoimmune bullous diseases, particularly bullous pemphigoid, has been observed in case reports, series, and epidemiological studies. Psoriasis usually precedes the onset of bullous pemphigoid and patients with both conditions typically have a milder presentation of bullous pemphigoid. It has been suggested that some cases of bullous pemphigoid with comorbid psoriasis may actually correspond to a rare form known as anti-laminin gamma-1 pemphigoid. The pathomechanisms of the association between psoriasis and bullous pemphigoid remain unclear, but the epitope spreading hypothesis is the most widely accepted explanation.
The coexistence of psoriasis with autoimmune bullous diseases (AIBDs), particularly bullous pemphigoid (BP), has been documented in case reports and series, as well as in epidemiological studies. The onset of psoriasis precedes that of BP in the majority of cases. Patients with concomitant BP and psoriasis are generally younger at the onset of BP and present with fewer erosions and blisters as compared with patients suffering from isolated BP. Intriguingly, it has been speculated that some BP cases with comorbid psoriasis can actually correspond to anti-laminin gamma-1 pemphigoid, a rare form that was recently recognized as a distinct entity and which can mimic BP and/or other subepidermal AIBDs. The pathomechanisms underlying the BP-psoriasis association have not yet been identified, although several hypotheses have been proposed. The most credited among such hypotheses involves the so-called epitope spreading phenomenon, with tissue injury secondary to a primary inflammatory process (i.e., psoriasis) leading to the exposure of sequestered antigens evoking a secondary autoimmune disease (i.e., bullous pemphigoid). This narrative review aims to give a brief overview of the association between psoriasis and BP, examining epidemiological, clinical, and immunopathological features, the pathomechanisms underlying this association, the treatments for psoriasis incriminated as potential triggers of BP, and the therapeutic management of patients with psoriasis and BP.
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