Abstract Number: 105

A case-control study on the environmental triggers of autoimmune blistering disease

G. Bak1,2, M. Radjenovic2, D. Oh1,2, S. Venugopal2, D. F Murrell1,2 1

Meeting: 2018 Dermcoll

Session Information

Date: -

Session Title: Poster Presentations

Session Time: -

Background: Autoimmune blistering diseases (AIBD) are a group of chronic and potentially life-threatening skin diseases characterised by autoantibodies against adhesion proteins in the skin (1). Whilst there are known genetic predispositions, the role of exogenous factors in precipitating or exacerbating disease remains unclear. Environmental factors such as foods, drugs, viral infections, chemicals, UV exposure, trauma and emotional stress, have been implicated as potential triggers of immune dysregulation in susceptible individuals (2).
Aim: To determine the environmental factors that contribute to the development of AIBD, particularly pemphigus vulgaris (PV) and bullous pemphigoid (BP).
Method: AIBD patients were interviewed using a questionnaire on previous environmental and occupational exposures from 2009–2017. Controls matching for age, sex and area of residence, were sourced from the Australian Electoral Commission and from non-AIBD patients attending a private dermatologist clinic. Data was analysed using STATA software to compare exposure factors between cases and controls.
Results: There was a total of 25 PV cases versus 72 controls and 29 BP cases versus 84 controls. Factors significantly associated with PV included leeks (OR 3.34), mustard oil (OR 10.17) and multivitamins (OR 3.11), and mental stress (OR 5.76). Factors significantly associated with BP included green/herbal tea (OR 4.10), fish oil (OR 5.79), calcium (OR 6.65), and mental stress (OR 8.13). Other factors including sun exposure and smoking were not statistically significant.
Conclusion: Our study has identified several potentially causative factors of PV and BP, suggesting the need for further research and to consider environmental triggers in routine AIBD management.
1. Hertl M. Autoimmune Diseases of the Skin: Pathogenesis, Diagnosis, Management: Springer Vienna; 2013.
2. Patel F, Wilken R, Patel FB, Sultani H, Bustos I, Duong C, et al.Pathophysiology of Autoimmune Bullous Diseases: Nature Versus Nurture. Indian journal of dermatology. 2017;62(3):262–7.