{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:27:53Z","timestamp":1760236073887,"version":"build-2065373602"},"reference-count":85,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,10,22]],"date-time":"2021-10-22T00:00:00Z","timestamp":1634860800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Neuropsychiatric disorders are found to be associated with bullous pemphigoid (BP), an autoimmune subepidermal blistering disease. Antipsychotics have emerged as possible inducing factors of BP. However, large sample studies concerning BP associated with antipsychotics, as well as with specific mental disorders, are still lacking. Our review retrieved a few clinical studies and case reports on the topic, producing controversial results. We report for the first time a bipolar patient case presenting BP following five-month therapy with risperidone long-acting injectable (LAI). We hypothesize that the dermatological event is associated with the medication administered. The issue emerged during psychiatric consultation and was confirmed by histological examination, direct and indirect immunofluorescence studies, plus positive plasma and cutaneous BP180 and BP230 IgG. Neurodegeneration or neuroinflammation might represent a primary process leading to a cross-reactive immune response between neural and cutaneous antigens and contributing to self-tolerance failure. Furthermore, the time sequence of the shared biological mechanisms leading to clinical manifestations of the neuropsychiatric disorder and BP remains undefined. BP comorbid with bipolar disorder might occasionally represent a serious health risk and affect patients\u2019 physical and psychosocial quality of life. Thus, clinicians treating psychiatric patients should consider BP as a possible adverse effect of psychotropic medications.<\/jats:p>","DOI":"10.3390\/brainsci11111386","type":"journal-article","created":{"date-parts":[[2021,10,24]],"date-time":"2021-10-24T22:06:16Z","timestamp":1635113176000},"page":"1386","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0231-4025","authenticated-orcid":false,"given":"Michele","family":"Fabrazzo","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariangela","family":"Boccardi","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8995-9020","authenticated-orcid":false,"given":"Salvatore","family":"Cipolla","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7766-3430","authenticated-orcid":false,"given":"Raffaele","family":"Galiero","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Tucci","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Perris","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ester Livia","family":"Di Caprio","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesco","family":"Catapano","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Campania \u201cLuigi Vanvitelli\u201d, Largo Madonna delle Grazie 1, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9142-7848","authenticated-orcid":false,"given":"Ferdinando Carlo","family":"Sasso","sequence":"additional","affiliation":[{"name":"Department of Advanced Medical and Surgical Sciences, University of Campania \u201cLuigi Vanvitelli\u201d, Piazza Luigi Miraglia 2, 80138 Naples, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1159\/000356539","article-title":"The immunology of bipolar disorder","volume":"21","author":"Barbosa","year":"2014","journal-title":"Neuroimmunomodulation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1001\/jamapsychiatry.2013.1394","article-title":"Comorbidities and mortality in bipolar disorder: A Swedish national cohort study","volume":"70","author":"Crump","year":"2013","journal-title":"JAMA Psychiatry"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.jad.2018.10.360","article-title":"Impaired glucose metabolism in bipolar patients and response to mood stabilizer treatments","volume":"245","author":"Steardo","year":"2019","journal-title":"J. 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