Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature
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 ment...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/11/11/1386 |
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| author | Michele Fabrazzo Mariangela Boccardi Salvatore Cipolla Raffaele Galiero Claudia Tucci Francesco Perris Ester Livia Di Caprio Francesco Catapano Ferdinando Carlo Sasso |
| author_facet | Michele Fabrazzo Mariangela Boccardi Salvatore Cipolla Raffaele Galiero Claudia Tucci Francesco Perris Ester Livia Di Caprio Francesco Catapano Ferdinando Carlo Sasso |
| author_sort | Michele Fabrazzo |
| collection | DOAJ |
| description | 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’ physical and psychosocial quality of life. Thus, clinicians treating psychiatric patients should consider BP as a possible adverse effect of psychotropic medications. |
| first_indexed | 2024-03-10T05:40:27Z |
| format | Article |
| id | doaj.art-9be7a8789955484484d30825f9ea80f4 |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T05:40:27Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-9be7a8789955484484d30825f9ea80f42023-11-22T22:36:54ZengMDPI AGBrain Sciences2076-34252021-10-011111138610.3390/brainsci11111386Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the LiteratureMichele Fabrazzo0Mariangela Boccardi1Salvatore Cipolla2Raffaele Galiero3Claudia Tucci4Francesco Perris5Ester Livia Di Caprio6Francesco Catapano7Ferdinando Carlo Sasso8Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia 2, 80138 Naples, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Psychiatry, University of Campania “Luigi Vanvitelli”, Largo Madonna delle Grazie 1, 80138 Naples, ItalyDepartment of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Piazza Luigi Miraglia 2, 80138 Naples, ItalyNeuropsychiatric 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’ physical and psychosocial quality of life. Thus, clinicians treating psychiatric patients should consider BP as a possible adverse effect of psychotropic medications.https://www.mdpi.com/2076-3425/11/11/1386bipolar disorderrisperidone LAIantipsychoticsbullous pemphigoidconsultation–liaison psychiatryneuroinflammation |
| spellingShingle | Michele Fabrazzo Mariangela Boccardi Salvatore Cipolla Raffaele Galiero Claudia Tucci Francesco Perris Ester Livia Di Caprio Francesco Catapano Ferdinando Carlo Sasso Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature Brain Sciences bipolar disorder risperidone LAI antipsychotics bullous pemphigoid consultation–liaison psychiatry neuroinflammation |
| title | Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature |
| title_full | Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature |
| title_fullStr | Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature |
| title_full_unstemmed | Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature |
| title_short | Bipolar Patients and Bullous Pemphigoid after Risperidone Long-Acting Injectable: A Case Report and a Review of the Literature |
| title_sort | bipolar patients and bullous pemphigoid after risperidone long acting injectable a case report and a review of the literature |
| topic | bipolar disorder risperidone LAI antipsychotics bullous pemphigoid consultation–liaison psychiatry neuroinflammation |
| url | https://www.mdpi.com/2076-3425/11/11/1386 |
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