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Bullous Pemphigoid Not Associated With Increased Risk of Malignancy

Previous studies have inconclusive findings regarding the association of bullous pemphigoid and solid malignancies. A recent study published in The Journal of Dermatology found that patients with bullous pemphigoid do not have an overall increased risk of developing a solid malignancy.

The researchers conducted a population-based cohort study to analyze the risk of solid malignancy among patients with bullous pemphigoid and evaluate if a history of solid malignancy correlates with the development of subsequent bullous pemphigoid. In total, 3924 patients with bullous pemphigoid with age-, sex-, and race-matched patients without the disease (N=19,280) were included. Cox regression analysis was used to estimate adjusted hazard ratios (aHR), and logistic regression was used to determine adjusted odds ratios (aOR).

Overall, the incidence of solid malignancy among patients with bullous pemphigoid was 13.4 (95% CI, 11.6-15.3) per 1000 person-years. In comparison, the incidence among controls were 14.3 (95% CI, 13.5-15.1) per 1000 person-years. The authors found that bullous pemphigoid was not associated with an increased risk of solid malignancy (aHR, 2.56; 95% CI, 1.39-4.72) and that a history of solid malignancy was not related to risk of a subsequent diagnosis of bullous pemphigoid (aOR, 1.00; 95% CI, 0.90-1.10).

Further analysis revealed that patients with bullous pemphigoid had an increased risk of uterine cancer (aHR, 2.56; 95% CI, 1.39-4.72). In addition, patients with bullous pemphigoid and solid malignancy were older and male as well as had a high prevalence of smoking, higher burden of comorbidities, and comparable survival rates.

“Our findings argue against routine extended cancer screening for patients with incident BP, but raise the awareness of uterine cancer among females with BP,” concluded the study authors.

Kridin K, Hammers CM, Ludwig RJ, Cohen AD. Risk of solid malignancies in bullous pemphigoid: a large‐scale population‐based cohort study. J Dermatol. Published online December 28, 2020. doi:10.1111/1346-8138.15685

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