BackgroundBullous pemphigoid (BP) is the most frequent autoimmune blistering disease mainly affecting elderly patients. Among several published risk factors, a recent post hoc analysis linked anti‐BP180 autoantibodies (AABs) to fatal outcomes in BP. To date, this finding has not been confirmed independently.ObjectiveTo investigate the potential of anti‐BP180‐AAB levels as a marker of prognosis and to identify a cut‐off level indicative of an increased risk for early death. Secondly, to characterize parameters associated with mortality.MethodsRetrospective, single‐centre study of BP patients diagnosed between 2001 and 2012. Analyses included epidemiological and patient‐ and disease‐specific characteristics as well as immunological parameters at diagnosis and during follow‐up. Standardized mortality ratios as well as uni‐ and multivariate regression analyses were calculated.ResultsOne hundred patients (56 women, 44 men) with a median age of 81 years (interquartile range 74–86) were followed up for a median of 775 days (interquartile range 162–1617). One‐year mortality rates were 25.0% implying a 2.4‐fold increased risk of death compared with the general population. High anti‐BP180 autoantibody levels at diagnosis (CI95 1.30–2.89; P = 0.001), dementia (CI95 1.13–6.72; P =0.03), length of hospitalization (CI951.16–2.41; P = 0.01) and age (CI95 1.23–4.19; P = 0.009) correlated significantly with 1‐year mortality. BP180‐AAB concentrations of ≥61 U/mL characterized a subgroup of patients with a particular higher risk for early death compared with the general population (CI95 1.81–3.81; P < 0.0001).ConclusionIn bullous pemphigoid, serum concentrations of BP180 autoantibodies at diagnosis could help to identify patients at risk for death within the first year after diagnosis (cut‐off value 61 U/mL).

Summary Background and objectives It has been postulated that psoriasis is associated with tongue lesions and geographic tongue might be “oral psoriasis”. However, reports are inconclusive, prevalence rates vary and data for Europe are sparse. In this prospective case‐control study we investigated the point‐prevalence of tongue conditions in an Austrian cohort. Patients and methods Psoriasis patients and healthy volunteers were assessed regarding tongue and skin lesions, age, sex, smoking habits, allergies, onset of psoriasis, PASI scores and anti‐psoriatic treatment. Results We included 173 psoriasis patients, 58 women, 115 men (median age: 50 [37–60] years), and 173 volunteers, 79 women, 94 men (median age: 54 [43–64] years). Overall, 95 subjects had allergies, 64 psoriasis patients and 50 volunteers were smokers. Median age at onset of psoriasis was 26 (12–40) years, the median PASI score was 2 (0–4.1), most patients received ustekinumab (n = 47). Fissured tongue was significantly associated with psoriasis (25 [14.4 %] psoriasis patients, 13 [7.5 %] volunteers; P = 0.04). Geographic tongue was present in four individuals of each group (2.3%) and associated with smoking (P = 0.01) but not with psoriasis. Conclusions Overall, we found a low point‐prevalence of tongue lesions in this Austrian cohort. Psoriasis was associated with fissured tongue but not with geographic tongue. Thus, we cannot corroborate the hypothesis that geographic tongue is an oral manifestation of psoriasis.

Hintergrund und Ziele: Es wurde berichtet, dass Psoriasis mit Zungenläsionen assoziiert ist und dass die Lingua geographica eine Form "oraler Psoriasis" sein könnte. Allerdings ist die Studienlage unklar, die Prävalenzraten heterogen und aus Europa liegen nur wenige Daten vor. In dieser prospektiven Fall-Kontroll-Studie haben wir die Prävalenz von Zungenanomalien an einer österreichischen Kohorte untersucht.