The association between bullous pemphigoid and neurological disorders: A systematic review

Background: Studies suggest an association between neurological disorders and bullous pemphigoid. Objectives: The goal of this systematic review was to characterize the occurrence of neurological disorders in patients with bullous pemphigoid. Materials & methods: We performed a systematic review of the current English literature from 1984 to June 1^st,2015 for documented cases of coexistent BP and neurological disorders. Results: The literature search resulted in 53 articles meeting the inclusion criteria. Patients with bullous pemphigoid had an increased risk of stroke (OR: 4.43 [95% CI: 2.69-7.28]; p<0.001), dementia (OR: 5.48 [95% CI: 3.26-9.23]; p<0.001), Parkinson’s (OR: 3.06 [95% CI: 1.97-4.77]; p< 0.001), and epilepsy/seizures (OR: 22.88 [95% CI: 2.64-198.21]; p = 0.0045). Neurological disorders preceded bullous pemphigoid in the majority of cases with a mean time interval of 6.7 years. The one-year mortality was increased in bullous pemphigoid patients who had concomitant stroke (OR: 2.87 [95% CI: 1.67-4.96]; p<0.001). Conclusion: Bullous pemphigoid patients have an increased association with neurological disorders which may increase mortality.