{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T07:55:46Z","timestamp":1791446146432,"version":"4.3.3"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T00:00:00Z","timestamp":1786233600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Severe infection is associated with increased mortality in patients receiving systemic corticosteroid therapy, including those with bullous pemphigoid (BP). Cytomegalovirus (CMV) reactivation represents a highly probable and underrecognized cause of death in immunosuppressive individuals. The aim of this study was to evaluate the association between CMV reactivation and disease course in patients with BP, and to develop a clinical scoring system for the prediction and early detection of CMV reactivation. A retrospective analysis of 41 patients with BP who received systemic corticosteroid therapy in our institution was conducted. Clinical and laboratory data were evaluated to identify factors associated with CMV reactivation, and a scoring system was developed to support both prediction and detection. Compared with CMV\u2010negative BP patients, CMV\u2010positive patients exhibited a more severe and protracted course, characterized by a higher incidence of complications. In addition, CMV\u2010positive patients had more extensive areas of blistering and erosion than CMV\u2010negative patients. Neutrophil\u2010lymphocyte ratio, platelet count, eosinophil count, serum sodium concentration level, and systemic corticosteroid dose were identified as key indicators for predicting and early detection of CMV reactivation. The proposed scoring system demonstrated high sensitivity (95.5%) and specificity (89.5%) for detecting CMV reactivation. Timely initiation of anti\u2010CMV therapy following the detection of CMV reactivation was crucial for preventing fatal complications. A newly\u2010invented scoring system may serve as a useful tool for predicting and detecting CMV reactivation in BP. Early identification of high\u2010risk cases may enable timely anti\u2010CMV therapy to prevent CMV disease leading to better outcomes.<\/jats:p>","DOI":"10.1111\/1346-8138.70424","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T03:53:17Z","timestamp":1786333997000},"page":"1480-1490","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk and Impact of Cytomegalovirus Infection in Bullous Pemphigoid Patients Treated With Immunosuppressive Agents"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5439-3754","authenticated-orcid":false,"given":"Yoko Mitsuyama","family":"Narita","sequence":"first","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine  Mitaka Tokyo Japan"},{"name":"The Metropolitan Tama\u2010Nambu Chiiki Hospital  Tama Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5717","authenticated-orcid":false,"given":"Manabu","family":"Ohyama","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine  Mitaka Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-1298","authenticated-orcid":false,"given":"Yoshiko","family":"Mizukawa","sequence":"additional","affiliation":[{"name":"Department of Dermatology Kyorin University School of Medicine  Mitaka Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,9]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20199007"},{"key":"e_1_2_11_3_1","first-page":"72","article-title":"Mortality in Patients With Bullous Pemphigoid: A Retrospective Cohort Study, Systematic Review and Meta\u2010Analysis","volume":"99","author":"Kridin K.","year":"2019","journal-title":"Acta Dermato\u2010Venereologica"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljae219"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.6061\/clinics\/2015(07)09"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.08.052"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13799"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idcr.2018.02.008"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v2.i11.379"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.idcr.2020.e00925"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.180104"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.15409"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000362717"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ced\/llae372"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/jvc2.259"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1099\/vir.0.069872-0"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-016-2335-5"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.5021\/ad.2018.30.5.544"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01185"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113721"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40618-020-01301-w"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-06-291245"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199309000-00024"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.51.7193"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s002770050265"},{"issue":"3","key":"e_1_2_11_26_1","first-page":"397","article-title":"Multiple Autoantibodies Following Cytomegalovirus Infection: Virus Distribution and Specificity of Autoantibodies","volume":"64","author":"Bartholomaeus M. 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