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Different types of dementia, Parkinson's disease, cerebrovascular disorders and epilepsy all have a significant association with <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>, but patients with multiple sclerosis have the highest risk of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>. An existing neurological disorder appears to increase the risk for subsequent <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>, but an increased risk for developing some neurological diseases has also been reported following <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> diagnosis. <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> seems to be associated with several psychiatric diseases such as schizophrenia, uni\u2010 and bipolar disorder, schizotypal and delusional disorders, and personality disorders, but the risk ratios are usually lower than with neurological diseases. In addition to the skin, the <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> autoantigens <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>180 and <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>230 are expressed in the central nervous system. This finding together with the strong epidemiological association between neurological disorders and <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> has led to an assumption that neurodegeneration or neuroinflammation could lead to a cross\u2010reactive immunoresponse between neural and cutaneous antigens and the failure of self\u2010tolerance. A subpopulation of patients with Alzheimer's disease or Parkinson's disease have circulating IgG autoantibodies against <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>180, but currently their significance for the development of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> is unclear, because these antineural <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>180 antibodies neither bind to the cutaneous basement membrane nor cause <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>\u2010like symptoms. Further studies analysing large and well\u2010characterized populations of neurological and psychiatric patients are required to understand better the role of autoimmunization against neural <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content> autoantigens in the pathogenesis of <jats:styled-content style=\"fixed-case\">BP<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/exd.13401","type":"journal-article","created":{"date-parts":[[2017,7,5]],"date-time":"2017-07-05T03:26:42Z","timestamp":1499225202000},"page":"1228-1234","source":"Crossref","is-referenced-by-count":63,"title":["Neurological and psychiatric associations in bullous pemphigoid\u2014more than skin deep?"],"prefix":"10.1111","volume":"26","author":[{"given":"Anna\u2010Kaisa","family":"F\u00f6rsti","sequence":"first","affiliation":[{"name":"PEDEGO Research Unit University of Oulu Oulu Finland"},{"name":"Department of Dermatology and Medical Research Center Oulu Oulu University Hospital Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Huilaja","sequence":"additional","affiliation":[{"name":"PEDEGO Research Unit University of Oulu Oulu Finland"},{"name":"Department of Dermatology and Medical Research Center Oulu Oulu University Hospital Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enno","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of L\u00fcbeck L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8056-5949","authenticated-orcid":false,"given":"Kaisa","family":"Tasanen","sequence":"additional","affiliation":[{"name":"PEDEGO Research Unit University of Oulu Oulu Finland"},{"name":"Department of Dermatology and Medical Research Center Oulu Oulu University Hospital Oulu University Hospital Oulu Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,9,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.a180"},{"key":"e_1_2_10_3_1","first-page":"399","volume":"108","author":"Schmidt E.","year":"2011","journal-title":"Dtsch. 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