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Epidemiology of Autoimmune Bullous Diseases

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Abstract

Autoimmune bullous diseases are a heterogeneous group of diseases also in terms of epidemiological characteristics. Recent high-quality epidemiological studies have provided valuable new knowledge in this area. It has become clear that the incidence of bullous pemphigoid in Central Europe has at least doubled over the last decade and that incidences of the different autoimmune diseases vary considerably between geographical regions. The increased mortality risk as well as the association with neurological diseases in patients with bullous pemphigoid has been highlighted in several studies, raising the intriguing question about the link between the neurological and skin diseases in affected patients.

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References

  1. Shapira Y, Agmon-Levin N, Shoenfeld Y. Defining and analyzing geoepidemiology and human autoimmunity. J Autoimmun. 2010;34(3):J168–77.

    CAS  PubMed  Google Scholar 

  2. Arbuckle MR, McClain MT, Rubertone MV, et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N Engl J Med. 2003;349(16):1526–33.

    CAS  PubMed  Google Scholar 

  3. Li N, Aoki V, Hans-Filho G, Rivitti EA, Diaz LA. The role of intramolecular epitope spreading in the pathogenesis of endemic pemphigus foliaceus (fogo selvagem). J Exp Med. 2003;197(11):1501–10.

    PubMed Central  CAS  PubMed  Google Scholar 

  4. Ortega Loayza AG, Ramos W, Elgart G, et al. Antibodies against desmoglein 1 in healthy subjects in endemic and nonendemic areas of pemphigus foliaceus (fogo selvagem) in Peru. Int J Dermatol. 2006;45(5):538–42.

    PubMed  Google Scholar 

  5. Qaqish BF, Prisayanh P, Qian Y, et al. Development of an IgG4-based predictor of endemic pemphigus foliaceus (fogo selvagem). J Invest Dermatol. 2009;129(1):110–8.

    PubMed Central  CAS  PubMed  Google Scholar 

  6. Amagai M, Tsunoda K, Zillikens D, Nagai T, Nishikawa T. The clinical phenotype of pemphigus is defined by the anti-desmoglein autoantibody profile. J Am Acad Dermatol. 1999;40(2 Pt 1):167–70.

    CAS  PubMed  Google Scholar 

  7. Aboobaker J, Wojnarowska FT, Bhogal B, Black MM. Chronic bullous dermatosis of childhood—clinical and immunological features seen in African patients. Clin Exp Dermatol. 1991;16(3):160–4.

    CAS  PubMed  Google Scholar 

  8. Baican A, Baican C, Chiriac G, et al. Pemphigus vulgaris is the most common autoimmune bullous disease in northwestern Romania. Int J Dermatol. 2010;49(7):768–74.

    PubMed  Google Scholar 

  9. Chams-Davatchi C, Valikhani M, Daneshpazhooh M, et al. Pemphigus: analysis of 1209 cases. Int J Dermatol. 2005;44(6):470–6.

    PubMed  Google Scholar 

  10. Hahn K, Kippes W, Amagai M, Rzany B, Brocker EB, Zillikens D. Clinical aspects and immunopathology in 48 patients with pemphigus. Hautarzt. 2000;51(9):670–7.

    CAS  PubMed  Google Scholar 

  11. Kumar KA. Incidence of pemphigus in Thrissur district, south India. Indian J Dermatol Venereol Leprol. 2008;74(4):349–51.

    PubMed  Google Scholar 

  12. Nanda A, Dvorak R, Al-Saeed K, Al-Sabah H, Alsaleh QA. Spectrum of autoimmune bullous diseases in Kuwait. Int J Dermatol. 2004;43(12):876–81.

    PubMed  Google Scholar 

  13. Salmanpour R, Shahkar H, Namazi MR, Rahman-Shenas MR. Epidemiology of pemphigus in south-western Iran: a 10-year retrospective study (1991–2000). Int J Dermatol. 2006;45(2):103–5.

    CAS  PubMed  Google Scholar 

  14. Mahe A, Flageul B, Cisse I, Keita S, Bobin P. Pemphigus in Mali: a study of 30 cases. Br J Dermatol. 1996;134(1):114–9.

    CAS  PubMed  Google Scholar 

  15. Micali G, Musumeci ML, Nasca MR. Epidemiologic analysis and clinical course of 84 consecutive cases of pemphigus in eastern Sicily. Int J Dermatol. 1998;37(3):197–200.

    CAS  PubMed  Google Scholar 

  16. Tallab T, Joharji H, Bahamdan K, Karkashan E, Mourad M, Ibrahim K. The incidence of pemphigus in the southern region of Saudi Arabia. Int J Dermatol. 2001;40(9):570–2.

    CAS  PubMed  Google Scholar 

  17. Uzun S, Durdu M, Akman A, et al. Pemphigus in the Mediterranean region of Turkey: a study of 148 cases. Int J Dermatol. 2006;45(5):523–8.

    PubMed  Google Scholar 

  18. Bastuji-Garin S, Souissi R, Blum L, et al. Comparative epidemiology of pemphigus in Tunisia and France: unusual incidence of pemphigus foliaceus in young Tunisian women. J Invest Dermatol. 1995;​104(2):302–5.

    CAS  PubMed  Google Scholar 

  19. V’Lckova-Laskoska MT, Laskoski DS, Kamberova S, Caca-Biljanovska N, Volckova N. Epidemiology of pemphigus in Macedonia: a 15-year retrospective study (1990–2004). Int J Dermatol. 2007;46(3):253–8.

    PubMed  Google Scholar 

  20. Amin MN, Islam AZ. Clinical, histologic and immunologic features of pemphigus in Bangladesh. Int J Dermatol. 2006;45(11):1317–8.

    PubMed  Google Scholar 

  21. Krain LS. Pemphigus. Epidemiologic and survival characteristics of 59 patients, 1955–1973. Arch Dermatol. 1974;110(6):862–5.

    CAS  PubMed  Google Scholar 

  22. Zaraa I, Kerkeni N, Ishak F, et al. Spectrum of autoimmune blistering dermatoses in Tunisia: an 11-year study and a review of the literature. Int J Dermatol. 2011;50(8):939–44.

    PubMed  Google Scholar 

  23. Golusin Z, Poljacki M, Jovanovic M, Ethuran V, Stojanovic S, Rajic N. Some epidemiological features of pemphigus chronicus in south Vojvodina: a 12-year retrospective study. Int J Dermatol. 2005;44(9):792–3.

    PubMed  Google Scholar 

  24. Goncalves GA, Brito MM, Salathiel AM, Ferraz TS, Alves D, Roselino AM. Incidence of pemphigus vulgaris exceeds that of pemphigus foliaceus in a region where pemphigus foliaceus is endemic: analysis of a 21-year historical series. An Bras Dermatol. 2011;86(6):1109–12.

    PubMed  Google Scholar 

  25. Hietanen J, Salo OP. Pemphigus: an epidemiological study of patients treated in Finnish hospitals between 1969 and 1978. Acta Derm Venereol. 1982;62(6):491–6.

    CAS  PubMed  Google Scholar 

  26. Marazza G, Pham HC, Scharer L, et al. Incidence of bullous pemphigoid and pemphigus in Switzerland: a 2-year prospective study. Br J Dermatol. 2009;161(4):861–8.

    CAS  PubMed  Google Scholar 

  27. Michailidou EZ, Belazi MA, Markopoulos AK, Tsatsos MI, Mourellou ON, Antoniades DZ. Epidemiologic survey of pemphigus vulgaris with oral manifestations in northern Greece: retrospective study of 129 patients. Int J Dermatol. 2007;46(4):356–61.

    PubMed  Google Scholar 

  28. Pisanti S, Sharav Y, Kaufman E, Posner LN. Pemphigus vulgaris: incidence in Jews of different ethnic groups, according to age, sex, and initial lesion. Oral Surg Oral Med Oral Pathol. 1974;38(3):382–7.

    CAS  PubMed  Google Scholar 

  29. Simon DG, Krutchkoff D, Kaslow RA, Zarbo R. Pemphigus in Hartford County, Connecticut, from 1972 to 1977. Arch Dermatol. 1980;116(9):1035–7.

    CAS  PubMed  Google Scholar 

  30. Thomas M, Paul C, Berard E, et al. Incidence of auto-immune pemphigus in the Midi-Pyrenees region in 2002–2006. Dermatology. 2010;220(2):97–102.

    CAS  PubMed  Google Scholar 

  31. Adam BA. Bullous diseases in Malaysia: epidemiology and natural history. Int J Dermatol. 1992;​31(1):42–5.

    CAS  PubMed  Google Scholar 

  32. Morini JP, Jomaa B, Gorgi Y, et al. Pemphigus foliaceus in young women. An endemic focus in the Sousse area of Tunisia. Arch Dermatol. 1993;129(1):69–73.

    CAS  PubMed  Google Scholar 

  33. Tsankov N, Vassileva S, Kamarashev J, Kazandjieva J, Kuzeva V. Epidemiology of pemphigus in Sofia, Bulgaria. A 16-year retrospective study (1980–1995). Int J Dermatol. 2000;39(2):104–8.

    CAS  PubMed  Google Scholar 

  34. Bertram F, Brocker EB, Zillikens D, Schmidt E. Prospective analysis of the incidence of autoimmune bullous disorders in Lower Franconia, Germany. J Dtsch Dermatol Ges. 2009;7(5):434–40.

    PubMed  Google Scholar 

  35. Hahn-Ristic K, Rzany B, Amagai M, Brocker EB, Zillikens D. Increased incidence of pemphigus vulgaris in southern Europeans living in Germany compared with native Germans. J Eur Acad Dermatol Venereol. 2002;16(1):68–71.

    CAS  PubMed  Google Scholar 

  36. Bozdag K, Bilgin I. Epidemiology of pemphigus in the western region of Turkey: retrospective analysis of 87 patients. Cutan Ocul Toxicol. 2012;31:280–5.

    CAS  PubMed  Google Scholar 

  37. Langan SM, Smeeth L, Hubbard R, Fleming KM, Smith CJ, West J. Bullous pemphigoid and pemphigus vulgaris—incidence and mortality in the UK: population based cohort study. BMJ. 2008;337:a180.

    PubMed Central  CAS  PubMed  Google Scholar 

  38. Huang YH, Kuo CF, Chen YH, Yang YW. Incidence, mortality, and causes of death of patients with pemphigus in Taiwan: a nationwide population-based study. J Invest Dermatol. 2012;132(1):92–7.

    CAS  PubMed  Google Scholar 

  39. Marinovic B, Lipozencic J, Jukic IL. Autoimmune blistering diseases: incidence and treatment in Croatia. Dermatol Clin. 2011;29(4):677–9.

    CAS  PubMed  Google Scholar 

  40. Groves RW, Bhogal B, Taghipour K, Caposciutti P, Saha M. Bullous pemphigoid: is the incidence of pemphigoid really increasing? BMJ. 2008;337:a1138.

    PubMed  Google Scholar 

  41. Bystryn JC, Steinman NM. The adjuvant therapy of pemphigus. An update. Arch Dermatol. 1996;​132(2):203–12.

    CAS  PubMed  Google Scholar 

  42. Risser J, Lewis K, Weinstock MA. Mortality of bullous skin disorders from 1979 through 2002 in the United States. Arch Dermatol. 2009;145(9):1005–8.

    PubMed  Google Scholar 

  43. Ahmed AR, Moy R. Death in pemphigus. J Am Acad Dermatol. 1982;7(2):221–8.

    CAS  PubMed  Google Scholar 

  44. Leshem YA, Katzenelson V, Yosipovitch G, David M, Mimouni D. Autoimmune diseases in patients with pemphigus and their first-degree relatives. Int J Dermatol. 2011;50(7):827–31.

    PubMed  Google Scholar 

  45. Firooz A, Mazhar A, Ahmed AR. Prevalence of autoimmune diseases in the family members of patients with pemphigus vulgaris. J Am Acad Dermatol. 1994;31(3 Pt 1):434–7.

    CAS  PubMed  Google Scholar 

  46. Wohl Y, Dreiher J, Cohen AD. Pemphigus and osteoporosis: a case-control study. Arch Dermatol. 2010;146(10):1126–31.

    PubMed  Google Scholar 

  47. Tee SI, Yosipovitch G, Chan YC, et al. Prevention of glucocorticoid-induced osteoporosis in immunobullous diseases with alendronate: a randomized, double-blind, placebo-controlled study. Arch Dermatol. 2012;148(3):307–14.

    CAS  PubMed  Google Scholar 

  48. Diaz LA, Sampaio SA, Rivitti EA, et al. Endemic pemphigus foliaceus (fogo selvagem). I. Clinical features and immunopathology. J Am Acad Dermatol. 1989;20(4):657–69.

    CAS  PubMed  Google Scholar 

  49. Diaz LA, Sampaio SA, Rivitti EA, et al. Endemic pemphigus foliaceus (fogo selvagem): II. Current and historic epidemiologic studies. J Invest Dermatol. 1989;92(1):4–12.

    CAS  PubMed  Google Scholar 

  50. Empinotti JC, Aoki V, Filgueira A, et al. Clinical and serological follow-up studies of endemic pemphigus foliaceus (fogo selvagem) in western Parana, Brazil (2001–2002). Br J Dermatol. 2006;155(2):446–50.

    CAS  PubMed  Google Scholar 

  51. Robledo MA, Prada S, Jaramillo D, Leon W. South American pemphigus foliaceus: study of an epidemic in El Bagre and Nechi, Colombia 1982 to 1986. Br J Dermatol. 1988;118(6):737–44.

    CAS  PubMed  Google Scholar 

  52. Abreu-Velez AM, Hashimoto T, Bollag WB, et al. A unique form of endemic pemphigus in northern Colombia. J Am Acad Dermatol. 2003;49(4):599–608.

    PubMed  Google Scholar 

  53. Abreu-Velez AM, Howard MS, Jiao Z, et al. Cardiac autoantibodies from patients affected by a new variant of endemic pemphigus foliaceus in Colombia, South America. J Clin Immunol. 2011;31(6):985–97.

    PubMed Central  CAS  PubMed  Google Scholar 

  54. Abreu-Velez AM, Howard MS, Yi H, Gao W, Hashimoto T, Grossniklaus HE. Neural system antigens are recognized by autoantibodies from patients affected by a new variant of endemic pemphigus foliaceus in Colombia. J Clin Immunol. 2011;31(3):356–68.

    CAS  PubMed  Google Scholar 

  55. Zimmermann J, Bahmer F, Rose C, Zillikens D, Schmidt E. Clinical and immunopathological spectrum of paraneoplastic pemphigus. J Dtsch Dermatol Ges. 2010;8(8):598–605.

    PubMed  Google Scholar 

  56. Leger S, Picard D, Ingen-Housz-Oro S, et al. Prognostic factors of paraneoplastic pemphigus. Arch Dermatol. 2012;16:1–8.

    Google Scholar 

  57. Anhalt GJ, Kim SC, Stanley JR, et al. Paraneoplastic pemphigus. An autoimmune mucocutaneous disease associated with neoplasia. N Engl J Med. 1990;323(25):1729–35.

    CAS  PubMed  Google Scholar 

  58. Joly P, Richard C, Gilbert D, et al. Sensitivity and specificity of clinical, histologic, and immunologic features in the diagnosis of paraneoplastic pemphigus. J Am Acad Dermatol. 2000;43(4):619–26.

    CAS  PubMed  Google Scholar 

  59. Anhalt GJ. Paraneoplastic pemphigus. Adv Dermatol. 1997;12:77–96; discussion 7.

    CAS  PubMed  Google Scholar 

  60. Ohyama M, Amagai M, Hashimoto T, Nousari HC, Anhalt GJ, Nishikawa T. Clinical phenotype and anti-desmoglein autoantibody profile in paraneoplastic pemphigus. J Am Acad Dermatol. 2001;44(4):593–8.

    CAS  PubMed  Google Scholar 

  61. Bernard P, Vaillant L, Labeille B, et al. Incidence and distribution of subepidermal autoimmune bullous skin diseases in three French regions. Bullous Diseases French Study Group. Arch Dermatol. 1995;131(1):48–52.

    CAS  PubMed  Google Scholar 

  62. Joly P, Baricault S, Sparsa A, et al. Incidence and mortality of bullous pemphigoid in France. J Invest Dermatol. 2012;132:1998–2004.

    CAS  PubMed  Google Scholar 

  63. Zillikens D, Wever S, Roth A, Weidenthaler-Barth B, Hashimoto T, Brocker EB. Incidence of autoimmune subepidermal blistering dermatoses in a region of central Germany. Arch Dermatol. 1995;131(8):957–8.

    CAS  PubMed  Google Scholar 

  64. Cozzani E, Parodi A, Rebora A, et al. Bullous pemphigoid in Liguria: a 2-year survey. J Eur Acad Dermatol Venereol. 2001;15(4):317–9.

    CAS  PubMed  Google Scholar 

  65. Wong SN, Chua SH. Spectrum of subepidermal immunobullous disorders seen at the National Skin Centre, Singapore: a 2-year review. Br J Dermatol. 2002;147(3):476–80.

    CAS  PubMed  Google Scholar 

  66. Gudi VS, White MI, Cruickshank N, et al. Annual incidence and mortality of bullous pemphigoid in the Grampian Region of north-east Scotland. Br J Dermatol. 2005;153(2):424–7.

    CAS  PubMed  Google Scholar 

  67. Serwin AB, Bokiniec E, Piascik M, Masny D, Chodynicka B. Epidemiological and clinical analysis of pemphigoid patients in northeastern Poland in 2000–2005. Med Sci Monit. 2007;13(8):CR360–4.

    PubMed  Google Scholar 

  68. Cordel N, Renier M, Samyn A, Fauvel C, Hope-Rapp E, Gilbert D. Epidemiology of bullous pemphigoid in Guadeloupe (French West Indies). Ann Dermatol Venereol. 2009;136(12):907–9.

    CAS  PubMed  Google Scholar 

  69. Bastuji-Garin S, Joly P, Lemordant P, et al. Risk factors for bullous pemphigoid in the elderly: a prospective case-control study. J Invest Dermatol. 2011;​131(3):637–43.

    CAS  PubMed  Google Scholar 

  70. Langan SM, Groves RW, West J. The relationship between neurological disease and bullous pemphigoid: a population-based case-control study. J Invest Dermatol. 2010;131(3):631–6.

    PubMed  Google Scholar 

  71. Taghipour K, Chi CC, Vincent A, Groves RW, Venning V, Wojnarowska F. The association of bullous pemphigoid with cerebrovascular disease and dementia: a case-control study. Arch Dermatol. 2010;146(11):1251–4.

    PubMed  Google Scholar 

  72. Bastuji-Garin S, Joly P, Picard-Dahan C, et al. Drugs associated with bullous pemphigoid. A case-control study. Arch Dermatol. 1996;132(3):272–6.

    CAS  PubMed  Google Scholar 

  73. Lever WF. Pemphigus. Medicine. 1953;32:1–123.

    CAS  PubMed  Google Scholar 

  74. Venning VA, Wojnarowska F. Lack of predictive factors for the clinical course of bullous pemphigoid. J Am Acad Dermatol. 1992;26(4):585–9.

    CAS  PubMed  Google Scholar 

  75. Roujeau JC, Lok C, Bastuji-Garin S, Mhalla S, Enginger V, Bernard P. High risk of death in elderly patients with extensive bullous pemphigoid. Arch Dermatol. 1998;134(4):465–9.

    CAS  PubMed  Google Scholar 

  76. Rzany B, Partscht K, Jung M, et al. Risk factors for lethal outcome in patients with bullous pemphigoid: low serum albumin level, high dosage of glucocorticosteroids, and old age. Arch Dermatol. 2002;138(7):903–8.

    PubMed  Google Scholar 

  77. Cordel N, Chosidow O, Hellot MF, et al. Neurological disorders in patients with bullous pemphigoid. Dermatology. 2007;215(3):187–91.

    PubMed  Google Scholar 

  78. Joly P, Benichou J, Lok C, et al. Prediction of survival for patients with bullous pemphigoid: a prospective study. Arch Dermatol. 2005;141(6):691–8.

    PubMed  Google Scholar 

  79. Joly P, Roujeau JC, Benichou J, et al. A comparison of oral and topical corticosteroids in patients with bullous pemphigoid. N Engl J Med. 2002;346(5):321–7.

    CAS  PubMed  Google Scholar 

  80. Cortes B, Marazza G, Naldi L, Combescure C, Borradori L. Mortality of bullous pemphigoid in Switzerland: a prospective study. Br J Dermatol. 2011;165(2):368–74.

    CAS  PubMed  Google Scholar 

  81. Parker SR, Dyson S, Brisman S, et al. Mortality of bullous pemphigoid: an evaluation of 223 patients and comparison with the mortality in the general population in the United States. J Am Acad Dermatol. 2008;59(4):582–8.

    PubMed  Google Scholar 

  82. Jedlickova H, Hlubinka M, Pavlik T, Semradova V, Budinska E, Vlasin Z. Bullous pemphigoid and internal diseases—a case-control study. Eur J Dermatol. 2010;20(1):96–101.

    PubMed  Google Scholar 

  83. Chen YJ, Wu CY, Lin MW, et al. Comorbidity profiles among patients with bullous pemphigoid: a nationwide population-based study. Br J Dermatol. 2011;165(3):593–9.

    CAS  PubMed  Google Scholar 

  84. Kulthanan K, Chularojanamontri L, Tuchinda P, Sirikudta W, Pinkaew S. Prevalence and clinical features of Thai patients with bullous pemphigoid. Asian Pac J Allergy Immunol. 2011;29(1):66–72.

    PubMed  Google Scholar 

  85. Jung M, Kippes W, Messer G, Zillikens D, Rzany B. Increased risk of bullous pemphigoid in male and very old patients: a population-based study on incidence. J Am Acad Dermatol. 1999;41(2 Pt 1):266–8.

    CAS  PubMed  Google Scholar 

  86. Waisbourd-Zinman O, Ben-Amitai D, Cohen AD, et al. Bullous pemphigoid in infancy: clinical and epidemiologic characteristics. J Am Acad Dermatol. 2008;58(1):41–8.

    PubMed  Google Scholar 

  87. Schmidt E, Kraensel R, Goebeler M, et al. Treatment of bullous pemphigoid with dapsone, methylprednisolone, and topical clobetasol propionate: a retrospective study of 62 cases. Cutis. 2005;76(3):205–9.

    PubMed  Google Scholar 

  88. Seppanen A, Suuronen T, Hofmann SC, Majamaa K, Alafuzoff I. Distribution of collagen XVII in the human brain. Brain Res. 2007;1158:50–6.

    PubMed  Google Scholar 

  89. Leung CL, Zheng M, Prater SM, Liem RK. The BPAG1 locus: alternative splicing produces multiple isoforms with distinct cytoskeletal linker domains, including predominant isoforms in neurons and muscles. J Cell Biol. 2001;154(4):691–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  90. Guo L, Degenstein L, Dowling J, et al. Gene targeting of BPAG1: abnormalities in mechanical strength and cell migration in stratified epithelia and neurologic degeneration. Cell. 1995;81(2):233–43.

    CAS  PubMed  Google Scholar 

  91. Taylor G, Venning V, Wojnarowska F, Welch K. Bullous pemphigoid and autoimmunity. J Am Acad Dermatol. 1993;29(2 Pt 1):181–4.

    CAS  PubMed  Google Scholar 

  92. Lindelof B, Islam N, Eklund G, Arfors L. Pemphigoid and cancer. Arch Dermatol. 1990;126(1):66–8.

    CAS  PubMed  Google Scholar 

  93. Ogawa H, Sakuma M, Morioka S, et al. The incidence of internal malignancies in pemphigus and bullous pemphigoid in Japan. J Dermatol Sci. 1995;9(2):136–41.

    CAS  PubMed  Google Scholar 

  94. Thorne JE, Anhalt GJ, Jabs DA. Mucous membrane pemphigoid and pseudopemphigoid. Ophthalmology. 2004;111(1):45–52.

    PubMed  Google Scholar 

  95. Ahmed AR, Hombal SM. Cicatricial pemphigoid. Int J Dermatol. 1986;25(2):90–6.

    CAS  PubMed  Google Scholar 

  96. Alexandre M, Brette MD, Pascal F, et al. A prospective study of upper aerodigestive tract manifestations of mucous membrane pemphigoid. Medicine (Baltimore). 2006;85(4):239–52.

    Google Scholar 

  97. Higgins GT, Allan RB, Hall R, Field EA, Kaye SB. Development of ocular disease in patients with mucous membrane pemphigoid involving the oral mucosa. Br J Ophthalmol. 2006;90(8):964–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  98. Laskaris G, Sklavounou A, Stratigos J. Bullous pemphigoid, cicatricial pemphigoid, and pemphigus vulgaris. A comparative clinical survey of 278 cases. Oral Surg Oral Med Oral Pathol. 1982;54(6):656–62.

    CAS  PubMed  Google Scholar 

  99. Egan CA, Lazarova Z, Darling TN, Yee C, Cote T, Yancey KB. Anti-epiligrin cicatricial pemphigoid and relative risk for cancer. Lancet. 2001;357(9271):1850–1.

    CAS  PubMed  Google Scholar 

  100. Matsushima S, Horiguchi Y, Honda T, et al. A case of anti-epiligrin cicatricial pemphigoid associated with lung carcinoma and severe laryngeal stenosis: review of Japanese cases and evaluation of risk for internal malignancy. J Dermatol. 2004;31(1):10–5.

    PubMed  Google Scholar 

  101. Leverkus M, Schmidt E, Lazarova Z, Brocker EB, Yancey KB, Zillikens D. Antiepiligrin cicatricial pemphigoid: an underdiagnosed entity within the spectrum of scarring autoimmune subepidermal bullous diseases? Arch Dermatol. 1999;135(9):1091–8.

    CAS  PubMed  Google Scholar 

  102. Nayar M, Wojnarowska F. No association between cicatricial pemphigoid and malignant disease. Br J Dermatol. 1991;125(2):193–4.

    CAS  PubMed  Google Scholar 

  103. Letko E, Gurcan HM, Papaliodis GN, Christen W, Foster CS, Ahmed AR. Relative risk for cancer in mucous membrane pemphigoid associated with antibodies to the beta4 integrin subunit. Clin Exp Dermatol. 2007;32(6):637–41.

    CAS  PubMed  Google Scholar 

  104. Malik M, Gurcan HM, Christen W, Ahmed AR. Relationship between cancer and oral pemphigoid patients with antibodies to alpha6-integrin. J Oral Pathol Med. 2007;36(1):1–5.

    CAS  PubMed  Google Scholar 

  105. Ambros-Rudolph CM, Mullegger RR, Vaughan-Jones SA, Kerl H, Black MM. The specific dermatoses of pregnancy revisited and reclassified: results of a retrospective two-center study on 505 pregnant patients. J Am Acad Dermatol. 2006;54(3):395–404.

    PubMed  Google Scholar 

  106. Kolodny RC. Herpes gestationis. A new assessment of incidence, diagnosis, and fetal prognosis. Am J Obstet Gynecol. 1969;104(1):39–45.

    CAS  PubMed  Google Scholar 

  107. Shornick JK, Bangert JL, Freeman RG, Gilliam JN. Herpes gestationis: clinical and histologic features of twenty-eight cases. J Am Acad Dermatol. 1983;8(2):214–24.

    CAS  PubMed  Google Scholar 

  108. Holmes RC, Black MM, Dann J, James DC, Bhogal B. A comparative study of toxic erythema of pregnancy and herpes gestationis. Br J Dermatol. 1982;106(5):499–510.

    CAS  PubMed  Google Scholar 

  109. Zurn A, Celebi CR, Bernard P, Didierjean L, Saurat JH. A prospective immunofluorescence study of 111 cases of pruritic dermatoses of pregnancy: IgM anti-basement membrane zone antibodies as a novel finding. Br J Dermatol. 1992;126(5):474–8.

    CAS  PubMed  Google Scholar 

  110. Harrington CI, Bleehen SS. Herpes gestationis: immunopathological and ultrastructural studies. Br J Dermatol. 1979;100(4):389–99.

    CAS  PubMed  Google Scholar 

  111. Russell B, Thorne NA. Herpes gestationis. Br J Dermatol. 1957;69(10):339–57.

    CAS  PubMed  Google Scholar 

  112. Shornick JK. Herpes gestationis. J Am Acad Dermatol. 1987;17(4):539–56.

    CAS  PubMed  Google Scholar 

  113. Jenkins RE, Hern S, Black MM. Clinical features and management of 87 patients with pemphigoid gestationis. Clin Exp Dermatol. 1999;24(4):255–9.

    CAS  PubMed  Google Scholar 

  114. Shornick JK, Black MM. Secondary autoimmune diseases in herpes gestationis (pemphigoid gestationis). J Am Acad Dermatol. 1992;26(4):563–6.

    CAS  PubMed  Google Scholar 

  115. Holmes RC, Black MM. Herpes gestationis. A possible association with autoimmune thyrotoxicosis (Graves’ disease). J Am Acad Dermatol. 1980;3(5):474–7.

    CAS  PubMed  Google Scholar 

  116. Wojnarowska F, Marsden RA, Bhogal B, Black MM. Chronic bullous disease of childhood, childhood cicatricial pemphigoid, and linear IgA disease of adults. A comparative study demonstrating clinical and immunopathologic overlap. J Am Acad Dermatol. 1988;19(5 Pt 1):792–805.

    CAS  PubMed  Google Scholar 

  117. Mulyowa GK, Jaeger G, Kabakyenga J, Brocker EB, Zillikens D, Schmidt E. Autoimmune subepidermal blistering diseases in Uganda: correlation of autoantibody class with age of patients. Int J Dermatol. 2006;45(9):1047–52.

    PubMed  Google Scholar 

  118. Piamphongsant T, Sirimachan S, Himmunknan P. Juvenile blistering diseases: the problems of diagnosis and treatment. Asian Pac J Allergy Immunol. 1986;4(2):133–7.

    CAS  PubMed  Google Scholar 

  119. Ajithkumar K, Kurian S, Jacob M, Pulimood S. Linear IgA bullous dermatosis in south India. Int J Dermatol. 1997;36(3):191–3.

    CAS  PubMed  Google Scholar 

  120. Denguezli M, Ben Nejma B, Nouira R, et al. Iga linear bullous dermatosis in children. A series of 12 Tunisian patients. Ann Dermatol Venereol. 1994;121(12):888–92.

    CAS  PubMed  Google Scholar 

  121. Mahe A, Flageul B, Bobin P. Bullous IgA linear dermatosis of children in Mali. Ann Dermatol Venereol. 1996;123(9):544–8.

    CAS  PubMed  Google Scholar 

  122. Kromminga A, Scheckenbach C, Georgi M, et al. Patients with bullous pemphigoid and linear IgA disease show a dual IgA and IgG autoimmune response to BP180. J Autoimmun. 2000;15(3):293–300.

    CAS  PubMed  Google Scholar 

  123. Godfrey K, Wojnarowska F, Leonard J. Linear IgA disease of adults: association with lymphoproliferative malignancy and possible role of other triggering factors. Br J Dermatol. 1990;123(4):447–52.

    CAS  PubMed  Google Scholar 

  124. Paige DG, Leonard JN, Wojnarowska F, Fry L. Linear IgA disease and ulcerative colitis. Br J Dermatol. 1997;136(5):779–82.

    CAS  PubMed  Google Scholar 

  125. Chen M, O’Toole EA, Sanghavi J, et al. The epidermolysis bullosa acquisita antigen (type VII collagen) is present in human colon and patients with crohn’s disease have autoantibodies to type VII collagen. J Invest Dermatol. 2002;118(6):1059–64.

    CAS  PubMed  Google Scholar 

  126. Zumelzu C, Le Roux-Villet C, Loiseau P, et al. Black patients of African descent and HLA-DRB1*15:03 frequency overrepresented in epidermolysis bullosa acquisita. J Invest Dermatol. 2011;131(12):2386–93.

    CAS  PubMed  Google Scholar 

  127. Kim JH, Kim YH, Kim SC. Epidermolysis bullosa acquisita: a retrospective clinical analysis of 30 cases. Acta Derm Venereol. 2011;91(3):307–12.

    CAS  PubMed  Google Scholar 

  128. Hundorfean G, Neurath MF, Sitaru C. Autoimmunity against type VII collagen in inflammatory bowel disease. J Cell Mol Med. 2010;14:2393–403.

    CAS  PubMed  Google Scholar 

  129. Oostingh GJ, Sitaru C, Zillikens D, Kromminga A, Luhrs H. Subclass distribution of type VII collagen-specific autoantibodies in patients with inflammatory bowel disease. J Dermatol Sci. 2005;37(3):182–4.

    CAS  PubMed  Google Scholar 

  130. Ishii N, Recke A, Mihai S, et al. Autoantibody-induced intestinal inflammation and weight loss in experimental epidermolysis bullosa acquisita. J Pathol. 2011;224(2):234–44.

    CAS  PubMed  Google Scholar 

  131. Yell JA, Mbuagbaw J, Burge SM. Cutaneous manifestations of systemic lupus erythematosus. Br J Dermatol. 1996;135(3):355–62.

    CAS  PubMed  Google Scholar 

  132. Cardinali C, Caproni M, Bernacchi E, Amato L, Fabbri P. The spectrum of cutaneous manifestations in lupus erythematosus—the Italian experience. Lupus. 2000;9(6):417–23.

    CAS  PubMed  Google Scholar 

  133. Gammon WR, Heise ER, Burke WA, Fine JD, Woodley DT, Briggaman RA. Increased frequency of HLA-DR2 in patients with autoantibodies to epidermolysis bullosa acquisita antigen: evidence that the expression of autoimmunity to type VII collagen is HLA class II allele associated. J Invest Dermatol. 1988;91(3):228–32.

    CAS  PubMed  Google Scholar 

  134. Dilling A, Rose C, Hashimoto T, Zillikens D, Shimanovich I. Anti-p200 pemphigoid: a novel autoimmune subepidermal blistering disease. J Dermatol. 2007;34(1):1–8.

    PubMed  Google Scholar 

  135. Gawkrodger DJ, Blackwell JN, Gilmour HM, Rifkind EA, Heading RC, Barnetson RS. Dermatitis herpetiformis: diagnosis, diet and demography. Gut. 1984;25(2):151–7.

    PubMed Central  CAS  PubMed  Google Scholar 

  136. Bolotin D, Petronic-Rosic V. Dermatitis herpetiformis. Part I. Epidemiology, pathogenesis, and clinical presentation. J Am Acad Dermatol. 2011;64(6):​1017–24; quiz 25–6.

    PubMed  Google Scholar 

  137. Dieterich W, Ehnis T, Bauer M, et al. Identification of tissue transglutaminase as the autoantigen of celiac disease. Nat Med. 1997;3(7):797–801.

    CAS  PubMed  Google Scholar 

  138. Sardy M, Karpati S, Merkl B, Paulsson M, Smyth N. Epidermal transglutaminase (TGase 3) is the autoantigen of dermatitis herpetiformis. J Exp Med. 2002;195(6):747–57.

    PubMed Central  CAS  PubMed  Google Scholar 

  139. Mobacken H, Kastrup W, Nilsson LA. Incidence and prevalence of dermatitis herpetiformis in western Sweden. Acta Derm Venereol. 1984;64(5):400–4.

    CAS  PubMed  Google Scholar 

  140. Reunala T, Lokki J. Dermatitis herpetiformis in Finland. Acta Derm Venereol. 1978;58(6):505–10.

    CAS  PubMed  Google Scholar 

  141. Smith JB, Tulloch JE, Meyer LJ, Zone JJ. The incidence and prevalence of dermatitis herpetiformis in Utah. Arch Dermatol. 1992;128(12):1608–10.

    CAS  PubMed  Google Scholar 

  142. Salmi TT, Hervonen K, Kautiainen H, Collin P, Reunala T. Prevalence and incidence of dermatitis herpetiformis: a 40-year prospective study from Finland. Br J Dermatol. 2011;165(2):354–9.

    CAS  PubMed  Google Scholar 

  143. Burrows D. The prevalence of dermatitis herpetiformis. Br J Dermatol. 1972;86(4):437.

    CAS  PubMed  Google Scholar 

  144. Hall RP, Clark RE, Ward FE. Dermatitis herpetiformis in two American blacks: HLA type and clinical characteristics. J Am Acad Dermatol. 1990;22(3):436–9.

    CAS  PubMed  Google Scholar 

  145. Shibahara M, Nanko H, Shimizu M, et al. Dermatitis herpetiformis in Japan: an update. Dermatology. 2002;204(1):37–42.

    CAS  PubMed  Google Scholar 

  146. Llorente-Alonso MJ, Fernandez-Acenero MJ, Sebastian M. Gluten intolerance: sex and age-related features. Can J Gastroenterol. 2006;20(11):719–22.

    PubMed Central  CAS  PubMed  Google Scholar 

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Acknowledgment

This work was supported by the Excellence Cluster “Inflammation at Interfaces” (EXC306/1; to E.S.), the European Community’s FP7 (Coordination Theme 1-HEALTH-F2–2008–200515), and the Swiss National Foundation for Scientific Research (31003A-121966 and 31003A-09811; both to L.B.).

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Schmidt, E., Borradori, L., Joly, P. (2015). Epidemiology of Autoimmune Bullous Diseases. In: Murrell, D. (eds) Blistering Diseases. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45698-9_21

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