Physical Activity and Risk of Autoimmune Bullous Skin Diseases: A Prospective Cohort Study

Authors

  • Shuai Ju Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China
  • Guowei Zhou Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China
  • Changmin Liu School of Foreign Languages and Literature, Shandong University, Jinan 250100, China
  • Fangfang Li Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China
  • Qingyu Hong Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China
  • Wanyao Liu Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China
  • Hong Liu Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China https://orcid.org/0000-0002-2083-0103
  • Jia Guo Department of Dermatology, Hunan Engineering Research Center of Skin Health and Disease, Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China; National Engineering Research Center of Personalized Diagnostic and Therapeutic Technology, Central South University, Changsha, Hunan 410008, China https://orcid.org/0009-0002-4903-508X

DOI:

https://doi.org/10.2340/actadv.v106.adv-2026-0705

Keywords:

physical activity, autoimmune bullous skin diseases, pemphigus, pemphigoid, bullous, body mass index

Abstract

Physical activity has been linked to immunee regulation in several autoimmune diseases, but its association with autoimmune bullous skin diseases (AIBD), mainly pemphigus and pemphigoid, has not been adequately evaluated. We examined the association between regular physical activity and incident AIBD in 476,057 UK Biobank participants. Multivariable-adjusted Cox models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for AIBD risk according to habitual physical activity. We also assessed joint associations with polygenic risk and performed mediation analysis. During a median follow-up of 15.21 years, 272 incident AIBD cases were documented, including 61 pemphigus and 211 pemphigoid cases. Physically active participants had a 31% lower risk of AIBD than inactive participants (adjusted HR 0.69, 95% CI 0.54–0.88). Similar associations were observed for pemphigus (HR 0.53) and pemphigoid (HR 0.72). Individuals with high genetic risk who were physically inactive had a higher risk than physically active individuals with low genetic risk (HR 2.12, 95% CI 1.47–3.07). In an exploratory mediation analysis, BMI accounted for 8.86 % of the association. These findings suggest that regular physical activity is associated with a lower risk of AIBD after adjustment for genetic susceptibility and other risk factors.

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Published

2026-09-22

How to Cite

Ju, S., Zhou, G., Liu, C., Li, F., Hong, Q., Liu, W., … Guo, J. (2026). Physical Activity and Risk of Autoimmune Bullous Skin Diseases: A Prospective Cohort Study. Acta Dermato-Venereologica, 106, adv–2026. https://doi.org/10.2340/actadv.v106.adv-2026-0705

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Vol. 106 (2026)

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