{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T03:23:59Z","timestamp":1789097039355,"version":"build-2803163510"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T00:00:00Z","timestamp":1724025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Anti\u2010p200 pemphigoid is a rare autoimmune subepidermal blistering disease. Although the phenomenon of epitope spreading has been reported to be common in anti\u2010p200 pemphigoid, the association between its clinical and immunoserological features has yet to be elucidated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Our aim was to compare the clinical and immunoserological characteristics of anti\u2010p200 pemphigoid patients with and without epitope spreading.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort study encompassing 30 patients with anti\u2010p200 pemphigoid between January 2015 and December 2022. The clinical and immunoserological characteristics of anti\u2010p200 pemphigoid were analyzed using combined immunoserological assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Epitope spreading was observed in 11 of 30 patients (36.7%) with anti\u2010p200 pemphigoid. Compared with patients in the non\u2010epitope spreading group, patients in the epitope spreading group showed more heterogeneous clinical presentations (<jats:italic>P<\/jats:italic>\u2009=\u20090.018), a higher proportion of mucosal involvement (<jats:italic>P<\/jats:italic>\u2009=\u20090.003), higher Bullous Pemphigoid Disease Area Index (BPDAI) scores for skin erosions\/blisters (<jats:italic>P<\/jats:italic>\u2009=\u20090.018), mucosal erosions\/blisters (<jats:italic>P<\/jats:italic>\u2009=\u20090.001), activity (<jats:italic>P<\/jats:italic>\u2009=\u20090.017) and total scores (<jats:italic>P<\/jats:italic>\u2009=\u20090.022), and required a higher initial dose of prednisone for disease control (<jats:italic>P<\/jats:italic>\u2009=\u20090.040).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study supported the idea that anti\u2010p200 pemphigoid was prone to epitope spreading. Anti\u2010p200 pemphigoid patients with epitope spreading are more likely to present heterogeneous clinical phenotypes, frequent mucosal involvement, and a more severe and recalcitrant disease course.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.17403","type":"journal-article","created":{"date-parts":[[2024,8,20]],"date-time":"2024-08-20T04:00:13Z","timestamp":1724126413000},"page":"359-366","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Clinical and immunoserological characteristics of anti\u2010p200 pemphigoid: Comparisons of patients with epitope spreading and non\u2010epitope spreading"],"prefix":"10.1111","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4120-4873","authenticated-orcid":false,"given":"Yuan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Dermatology, Institute of Dermatology Chinese Academy of Medical Sciences and Peking Union Medical College  Nanjing 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