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Bullous dermatoses carry mental health burden for patients

Bullous Pemphihgoid. Photo by Mohammad2018 via Wikimedia Commons

Many patients with bullous dermatoses experience depression, and the degree of that depression appears to be related to the severity of the disease, according to the results of a retrospective study published recently in JAMA Dermatology.

This systematic review identified 17 articles related to bullous skin disease and depression in the PubMed, Embase, PsycInfo, and Cochrane databases published between 1945 and February 2021. A total of 83,910 patients were identified (6,951 patients with bullous pemphigoid, 1,669 patients with pemphigus, and 79 patients with epidermolysis bullosa). Females comprised 55.2% of the patients studied.

While the prevalence of depressive symptoms among patients with bullous dermatoses ranged from 40% to 80%, an actual diagnosis of depression was much lower, ranging from 11.4% to 28%.

The authors note that while studies have associated other skin diseases such as atopic dermatitis and psoriasis with depressive comorbidities, this study indicates that it would be prudent for clinicians to conduct a regular assessment of psychiatric symptoms in patients with bullous dermatoses. They recommend “the use of treatment options that minimize psychiatric adverse effects for patients with severe disease is important to prevent worsening of mental health symptoms.”

The authors also stressed that adequate treatment of bullous dermatoses may be associated with a decrease in the mental health burden experienced by these patients.


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