A Systematic Review of Concomitant Bullous Pemphigoid and Psoriasis

Abstract

Background Many reports in the medical literature describe patients with concurrent psoriasis and bullous pemphigoid (BP), but little is known about these patients. Objective: To characterize patients with concurrent BP and psoriasis and their disease course. Methods We performed a systematic review of the English literature for all documented cases of coexistent BP and psoriasis. Results Our search yielded 76 cases meeting inclusion criteria. The male-to-female ratio was 2.3:1. The average age of onset of BP was 65 years. Prior to BP eruption, 38% of the patients had acute worsening of their psoriasis. Ultraviolet radiation therapy was the most cited cause of BP outbreak (25%). The most used systemic treatments for BP outbreak were corticosteroids (45%) and methotrexate (18%). Conclusion Patients with BP and psoriasis are clinically distinct. Providers should be aware of the association between these diseases and be able to choose treatments that do not exacerbate either disease.