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Association of bullous pemphigoid with malignancy: A systematic review and meta-analysis

Lihi Atzmony 1Ilit Mimouni 2Ofer Reiter 3Yael Anne Leshem 4Omar Taha 3Michael Gdalevich 5Emmilia Hodak 4Daniel Mimouni 4


Background: Studies evaluating whether malignancy rate is increased in patients with bullous pemphigoid (BP) have reached conflicting results. Objective: We sought to determine whether BP is associated with malignancy. Method: Medline, EMBASE, the Cochrane library, and reference lists of included studies were searched for comparative studies that evaluated the relationship between BP and malignancy. Data were analyzed on the basis of study design: cross-sectional, case control, and cohort. A meta-analysis was performed by using a random effects model to estimate pooled odds ratio. Results: The review included 8 studies. No association between BP and overall cancer was found for any of the study designs. Although a single cohort study reported an association with lymphoid leukemia and kidney and larynx cancer, a pooled analysis of case-control studies did not. A pooled analysis of cross-sectional studies found a significant association between BP and hematologic malignancies. Limitations: The paucity of well-designed studies hindered the possibility of proving or disproving the BP-cancer association. Conclusion: We did not find an association of BP with overall malignancy, but a possible association with hematologic malignancy was observed. Keywords: bullous dermatoses; bullous pemphigoid; cancer; epidemiology; malignancy.
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