Impact of COVID-19 on Autoimmune Bullous Diseases
Summary
Autoimmune bullous diseases (AIBDs) such as pemphigus and bullous pemphigoid are characterised by pathogenic autoantibodies that compromise skin and mucosal integrity, leading to painful blister formation. The advent of COVID-19 has introduced new layers of complexity for patients and clinicians alike. SARS-CoV-2 infection can trigger aberrant immune activation, occasionally precipitating new-onset blistering disease or exacerbating established AIBDs. At the same time, the systemic inflammation and lymphocyte perturbations seen in severe COVID-19 overlap with mechanisms implicated in AIBD pathogenesis. The pandemic has also disrupted routine dermatological care, causing delays in diagnosis, interruptions of immunosuppressive regimens and hesitancy around hospital attendance. Conversely, widespread vaccination campaigns have conferred protection against severe infection while raising concerns about rare vaccine-associated flares. Navigating these interconnected challenges requires careful scheduling of immunisation, judicious use of immunomodulators and close collaboration between dermatologists, immunologists and infectious disease specialists.
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Impact of COVID-19 on Autoimmune Bullous Diseases publication trend
The graph below shows the total number of articles in impact of covid-19 on autoimmune bullous diseases across all publications each year (not limited to Nature Index journals).
Technical terms
Autoimmune bullous diseases: A group of disorders characterised by autoantibodies targeting structural proteins in the skin and mucous membranes, leading to blister formation.
Pemphigus: A subset of AIBDs marked by antibodies against desmoglein proteins, resulting in intraepidermal blistering.
Bullous pemphigoid: An AIBD in which autoantibodies target the dermal–epidermal junction, causing tense subepidermal blisters.
Rituximab: A monoclonal antibody that depletes CD20+ B cells, used to treat refractory or severe AIBDs.
Immunosuppression: The reduction of immune system activity by pharmacological agents, often necessary for controlling autoimmune conditions but associated with increased infection risk.
References
- COVID-19 infection is associated with an elevated risk for autoimmune blistering diseases while COVID-19 vaccination decreases the risk: A large-scale population-based cohort study of 112 million individuals. Journal of the American Academy of Dermatology (2024).
- Pemphigus during the COVID-19 Epidemic: Infection Risk, Vaccine Responses and Management Strategies. Journal of Clinical Medicine (2022).
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