To the Editor.—
Spigel and Winkelmann have recently reported the association of cicatricial pemphigoid with rheumatoid arthritis (Archives 114:415-417, 1978). They have suggested that this association supports the concept that cicatricial pemphigoid and bullous pemphigoid are identical in their pathogenesis. My associates and I1 have reported a case of bullous pemphigoid that was associated with classical rheumatoid arthritis, as defined by the criteria of the American Rheumatism Association (ARA).2 To date, this is the only case, to our knowledge, of bullous pemphigoid associated with documented rheumatoid arthritis. In our report we stressed the importance of using diagnostic criteria. Drs Spigel and Winkelmann have not provided enough information to support the diagnosis of rheumatoid arthritis in any of the patients they presented. Only two of their four patients had positive rheumatoid factors, and both of these patients were elderly (67 and 78 years old). Svec and Veit3 have
Callen JP. Association of Cicatricial Pemphigoid and Rheumatoid Arthritis. Arch Dermatol. 1979;115(1):108. doi:10.1001/archderm.1979.04010010074033
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