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Tang CH, Sue YM, Chang CL, Wang CC. Risk of bullous pemphigoid and pemphigus in patients on chronic dialysis: A nationwide population-based cohort study. J Dermatol 2023; 50:1568-1575. [PMID: 37665203 DOI: 10.1111/1346-8138.16948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023]
Abstract
Bullous pemphigoid has a high incidence among dialysis patients. However, whether or not chronic dialysis is an independent risk factor of bullous pemphigoid remains unclear. We aimed to investigate the effect of chronic dialysis on the development of bullous pemphigoid and pemphigus. We performed a retrospective cohort study using records from Taiwan's National Health Insurance Research Database between 2008 and 2019. We identified a dialysis cohort that included patients on chronic hemodialysis and peritoneal dialysis, and the hazard ratios (HRs) for bullous pemphigoid and pemphigus were compared with those of a sex-, age-, and index-matched cohort, then the results were adjusted for various confounding factors. Among 93 538 patients on chronic dialysis and 93 538 patients in the control group, 287 and 139 developed incident bullous pemphigoid, and 45 and 35 developed incident pemphigus after a median follow-up of 3.7 and 5.6 years, respectively. The incidence rates of bullous pemphigoid in the dialysis patients and the control group were 74.2 and 25.2 per 100 000 person-years, respectively (difference between groups, P < 0.0001). The incidence rates of pemphigus in the dialysis patients and the control group were 11.6 and 6.3 per 100 000 person-years, respectively (difference between groups, P < 0.01). Cox proportional hazard adjustment showed the HR for bullous pemphigoid in dialysis patients was 2.12 (95% confidence interval [CI] 1.64-2.74, P < 0.0001) compared with the control group. Dialysis patients aged <75 years had an even higher risk of bullous pemphigoid development (5- to 8-fold) than the control group. The adjusted HR for pemphigus was not elevated in dialysis patients (adjusted HR 1.52, 95% CI 0.87-2.67, P = 0.14). Chronic dialysis is an independent risk factor for developing bullous pemphigoid, but not a risk factor for pemphigus. Physicians should be aware of the predisposition of chronic dialysis patients to bullous pemphigoid.
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Affiliation(s)
- Chao-Hsiun Tang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Yuh-Mou Sue
- Division of Nephrology, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Division of Nephrology, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chia-Li Chang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Chia-Chen Wang
- Department of Dermatology, Cardinal Tien Hospital, New Taipei City, Taiwan
- School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
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Kakehi Y, Miyagawa F, Ogawa K, Hashimoto T, Asada H. Case of anti-laminin γ1 pemphigoid associated with ulcerative colitis and acquired perforating dermatosis. J Dermatol 2020; 48:e35-e36. [PMID: 32981121 DOI: 10.1111/1346-8138.15624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/15/2020] [Accepted: 08/28/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Yumi Kakehi
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Fumi Miyagawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Kohei Ogawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Osaka City University Graduate School of Medicine, Abeno, Japan
| | - Hideo Asada
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
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Schauer F, Kern JS, Virtic O, Technau-Hafsi K, Meiss F, Thoma K, Athanasiou I, Sitaru C, Di Zenzo G, Izumi K, Nishie W, Shimizu H, Bruckner-Tuderman L, Kiritsi D. A new clinical variant of acquired reactive perforating dermatosis-like bullous pemphigoid. Br J Dermatol 2019; 180:231-232. [PMID: 30188568 DOI: 10.1111/bjd.17146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- F Schauer
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - J S Kern
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
- Royal Melbourne Hospital, Parkville and Box Hill Hospital - Monash University Eastern Health Clinical School, Box Hill, Victoria, Australia
| | - O Virtic
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - K Technau-Hafsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - F Meiss
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - K Thoma
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - I Athanasiou
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - C Sitaru
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - G Di Zenzo
- Laboratory of Molecular and Cell Biology, Istituto Dermopatico dell'Immacolata (IDI)-IRCCS, FLMM, Rome, Italy
| | - K Izumi
- Department of Dermatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - W Nishie
- Department of Dermatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - H Shimizu
- Department of Dermatology, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - L Bruckner-Tuderman
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
| | - D Kiritsi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Hauptstraße 7, 79104, Freiburg, Germany
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Maki N, Nishie W, Takazawa M, Kakurai M, Yamada T, Umemoto N, Kawase M, Izumi K, Shimizu H, Demitsu T. Dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid in a patient with acquired reactive perforating collagenosis. J Dermatol 2018; 45:600-602. [PMID: 29446164 DOI: 10.1111/1346-8138.14254] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 01/15/2018] [Indexed: 11/28/2022]
Abstract
Bullous pemphigoid (BP) is a common autoimmune blistering disorder with unknown etiology. Recently, increasing numbers of BP cases which developed under the medication with dipeptidyl peptidase-4 inhibitors (DPP4i), widely used antihyperglycemic drugs, have been reported in published works. Here, we report a case of DPP4i (teneligliptin)-associated BP that developed in a 70-year-old Japanese man. Interestingly, the patient had acquired reactive perforating collagenosis (ARPC), which is also known to be associated with the onset of BP. In the present case, clinical, histopathological and immunological findings suggested that DPP4i rather than ARPC was associated with the onset of BP.
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Affiliation(s)
- Nobuki Maki
- Department of Dermatology, Akita National Hospital, Akita, Japan
| | - Wataru Nishie
- Department of Dermatology, Hokkaido University School of Medicine, Hokkaido, Japan
| | - Maya Takazawa
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Maki Kakurai
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Tomoko Yamada
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Naoka Umemoto
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Masaaki Kawase
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Kentaro Izumi
- Department of Dermatology, Hokkaido University School of Medicine, Hokkaido, Japan
| | - Hiroshi Shimizu
- Department of Dermatology, Hokkaido University School of Medicine, Hokkaido, Japan
| | - Toshio Demitsu
- Department of Dermatology, Jichi Medical University Saitama Medical Center, Saitama, Japan
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