ArticleDermatology (Basel, Switzerland)2026
Comparative Clinical and Histological Analysis of Bullous Pemphigoid: Immunotherapy-Associated versus Spontaneous Onset Cases.
Article in Dermatology (Basel, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionImmune checkpoint blockade (ICB) therapy can be associated with the development of bullous pemphigoid (BP). To characterize clinical, histological, and serological characteristics, we compared immune-related bullous pemphigoid (irBP) and spontaneous bullous pemphigoid (sBP) considering clinical, serological, and histopathological character.
methods149 BP patients treated at the University Hospital Zurich between 2015 and 2024 were identified retrospectively. Demographic and serological data were obtained from electronic records. Hematoxylin-eosin-stained biopsies were semi-quantitatively evaluated for immune cell infiltrates, split formation, and infiltration patterns.
resultsFrom the total of 149 cases, 17 were irBP and 132 were sBP. Patients affected by irBP were predominantly males (94%), females were slightly overrepresented in sBP (51.5%) and BP was less often suspected at presentation (59% vs. 85% in sBP). Anti-BP230 antibodies were more frequently elevated in sBP (64.4% vs. 23.5% in irBP). Histologically, irBP cases showed denser eosinophilic and lymphocytic infiltrates, as assessed by semi-quantitative scoring.
conclusionirBP differs from sBP by showing denser immune-infiltrates, lower rates of elevated anti-BP230 antibodies and predominantly affect males. These observations suggest that irBP represents a distinct subtype and highlight the need for diagnostic awareness in the setting of ICB therapy.
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