An 80-year-old man with a 6-year history of dementia develops tense blisters on the trunk and limbs. Direct immunofluorescence confirms bullous pemphigoid. Which clinical association, now well documented in large cohort studies, is relevant to his case?
- A Increased risk of bullous pemphigoid in patients with neurological disease including dementia and stroke ✓
- B Protective effect of dementia against antibody-mediated blistering diseases
- C Association limited exclusively to drug-induced bullous pemphigoid
- D Higher risk only when the patient also carries HLA-DQ2
Correct answer: A. Increased risk of bullous pemphigoid in patients with neurological disease including dementia and stroke
Explanation
Large epidemiological studies show a strong association between bullous pemphigoid and neurological diseases such as dementia, stroke, Parkinson disease and epilepsy. BP180 and BP230 are expressed in nervous tissue, which may expose neural epitopes and trigger cross-reactive autoimmunity. This association applies to classic bullous pemphigoid, not only drug-induced cases, and is unrelated to HLA-DQ2.
Reference: European Handbook of Dermatological Treatments / Rook's Textbook of Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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