{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:35:24Z","timestamp":1788388524907,"version":"build-2803163510"},"reference-count":58,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009128","name":"Research for Patient Benefit Programme","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bullous pemphigoid (BP) is a rare, serious autoimmune skin disease that is more common in older people. Numerous drugs and conditions have been previously associated with BP, but no study has explored patterns of risk factors. It is important to identify characteristics of people at risk of BP to help raise clinical suspicion. Diagnostic delay can lead to serious symptoms and poor quality of life.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To identify patterns of drug prescriptions, comorbidities and sociodemographic characteristics of people with BP prior to diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a 1 : 1 case\u2013control study (1998\u20132021) using routinely collected primary care data from the\u00a0Clinical Practice Research Datalink. Cases were matched to controls by age, sex and clinical practice. We ran clustering analysis to identify groups of cases with similar characteristics. We repeated the analysis for controls to verify whether these characteristics are unique or more common in cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>There were 16 624 cases and 16 624 controls (median age 80\u2005years; 55.6% women). Eight case\/control clusters were identified. Four case clusters included people who were all prescribed penicillinase-resistant penicillins. Statins were prescribed in six BP and four control clusters. Multiple sclerosis was rare (1\u20132% of\u00a0people) but unique in case clusters (five of eight).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Penicillinase-resistant penicillins and statins were more often prescribed prior to BP diagnosis. Healthcare professionals should be vigilant for skin reactions in older people following these medications, particularly penicillinase-\u00adresistant penicillins. Due to low BP prevalence, we do not suggest preventative discontinuation of highlighted drugs. We also propose checking for skin reactions following a multiple sclerosis diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ced\/llag144","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T11:31:20Z","timestamp":1774956680000},"page":"1611-1620","source":"Crossref","is-referenced-by-count":1,"title":["Identifying characteristics of people with bullous pemphigoid prior to diagnosis using clustering analysis: a UK population-based case\u2013control study"],"prefix":"10.1093","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9973-3667","authenticated-orcid":false,"given":"Shreya","family":"Iyer","sequence":"first","affiliation":[{"name":"School of Computer Science, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5462-6170","authenticated-orcid":false,"given":"Mikolaj","family":"Swiderski","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3030-5257","authenticated-orcid":false,"given":"Yana","family":"Vinogradova","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1646-8321","authenticated-orcid":false,"given":"Roger D","family":"Knaggs","sequence":"additional","affiliation":[{"name":"School of Pharmacy, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen E","family":"Harman","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University Hospitals of Leicester NHS Trust , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4920-6718","authenticated-orcid":false,"given":"Rowan H","family":"Harwood","sequence":"additional","affiliation":[{"name":"School of Health Sciences, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5470-276X","authenticated-orcid":false,"given":"Vibhore","family":"Prasad","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham ,","place":["UK"]},{"name":"Department of Population Health Sciences, King\u2019s College London , London ,","place":["UK"]},{"name":"NHS Nottinghamshire, Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8532-3006","authenticated-orcid":false,"given":"Monica S M","family":"Persson","sequence":"additional","affiliation":[{"name":"Swedish Rheumatism Association , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3665-9774","authenticated-orcid":false,"given":"Carron","family":"Layfield","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4094-7680","authenticated-orcid":false,"given":"Grazziela","family":"Figueredo","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2443-5100","authenticated-orcid":false,"given":"Sonia","family":"Gran","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Nottingham , Nottingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"2026081712362838700_llag144-B1","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1111\/bjd.19022","article-title":"Incidence, prevalence and mortality of bullous pemphigoid in England 1998\u20132017: a population-based cohort study","volume":"184","author":"Persson","year":"2021","journal-title":"Br J Dermatol"},{"key":"2026081712362838700_llag144-B2","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1093\/bjd\/ljae416","article-title":"Association between drugs and vaccines commonly prescribed to older people and bullous pemphigoid: a case\u2013control study","volume":"192","author":"Swiderski","year":"2024","journal-title":"Br J Dermatol"},{"key":"2026081712362838700_llag144-B3","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1590\/abd1806-4841.20164935","article-title":"Quality of life, depression, anxiety and loneliness in patients with bullous pemphigoid. 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