Bullous Pemphigoid in Iranian Patients: A Descriptive Study on 122 Cases
AbstractBullous pemphigoid is an immunobullous disease with high mortality and morbidity. Different aspects and characteristics in the patients vary in different areas in the world. Our objective was to study clinical and demographic characteristics of bullous pemphigoid in Iranian patients. In a retrospective descriptive study, we reviewed 122 patients with bullous pemphigoid within 1987-2007. Demographic characteristics, clinical manifestations, treatment, relapses and outcome were evaluated. The mean age of 122 patients was 65 ± 18.11 years including 35.2% male and 64.8% female. The most common manifestations were cutaneous bullae (97.5%). 27% had oral lesions. 30.3% had eosinophillia. 90 patients(73.8%) received oral prednisolone, 29 patients (23.8%) topical steroid, 2 patients tetracycline and 1 patient dapsone. 89 patients were followed after admission. Out of them 44 patients experienced first relapse and 22 patients second relapse. 41 cases (46%) were completely controlled. 11 cases (12%) were not controlled. Clinical and general characteristics of bullous pemphigoid patients differ in various regions in the world.
Bilic M, Mutasim D. Bullous pemphigoid. In: Enna SJ, David BB, editors. xPharm: The Comprehensive Pharmacology Reference. New York, NY: Elsevier Science Inc.; 2007. p. 1-9.
Mutasim DF. Management of autoimmune bullous diseases: pharmacology and therapeutics. J Am Acad Dermatol 2004;51(6):859-77; quiz 878-80.
Rzany B, Partscht K, Jung M, Kippes W, Mecking D, Baima B, Prudlo C, Pawelczyk B, Messmer EM, Schuhmann M, Sinkgraven R, Büchner L, Büdinger L, Pfeiffer C, Sticherling M, et al. Risk factors for lethal outcome in patients with bullous pemphigoid: low serum albumin level, high dosage of glucocorticosteroids, and old age. Arch Dermatol 2002;138(7):903-8.
Langan SM, Smeeth L, Hubbard R, Fleming KM, Smith CJ, West J. Bullous pemphigoid and pemphigus vulgaris-- incidence and mortality in the UK: population based cohort study. BMJ 2008;337:a180.
Adam BA. Bullous diseases in Malaysia: epidemiology and natural history. Int J Dermatol 1992;31(1):42-5.
Gudi VS, White MI, Cruickshank N, Herriot R, Edwards SL, Nimmo F, Ormerod AD. Annual incidence and mortality of bullous pemphigoid in the Grampian Region of North-east Scotland. Br J Dermatol 2005;153(2):424-7..
Roujeau JC, Lok C, Bastuji-Garin S, Mhalla S, Enginger V, Bernard P. High risk of death in elderly patients with extensive bullous pemphigoid. Arch Dermatol 1998;134(4):465-9.
Colbert RL, Allen DM, Eastwood D, Fairley JA. Mortality rate of bullous pemphigoid in a US medical center. J Invest Dermatol 2004;122(5):1091-5.
Nasiri S, Mollayi F, Vasheghani Farahani M. Bullous pemphigoid: A descriptive study on patients admitted in Loghman Hakim Hospital in Tehran in 1992-97. Iran J Dermatol 2000;3(12):34-7.
Triki Ben Ammar S, Mokhtar I, Fazaa B, Kharfi M, Kamoun MR. Profile of bullous pemphigoid. A report of 47 cases. Tunis Med 2000;78(10):584-8.
Serwin AB, Bokiniec E, Piascik M, Masny D, Chodynicka B. Epidemiological and clinical analysis of pemphigoid patients in northeastern Poland in 2000-2005. Med Sci Monit 2007;13(8):CR360-4.
Nanda A, Al-Saeid K, Al-Sabah H, Dvorak R, Alsaleh QA. Clinicoepidemiological features and course of 43 cases of bullous pemphigoid in Kuwait. Clin Exp Dermatol 2006;31(3):339-42.
Joly P, Benichou J, Lok C, Hellot MF, Saiag P, Tancrede- Bohin E, Sassolas B, Labeille B, Doutre MS, Gorin I, Pauwels C, Chosidow O, Caux F, Estève E, Dutronc Y, et al. Prediction of survival for patients with bullous pemphigoid: a prospective study. Arch Dermatol 2005;141(6):691-8.
Chang YT, Liu HN, Wong CK. Bullous pemphigoid: a report of 86 cases from Taiwan. Clin Exp Dermatol 1996;21(1):20-2.
Chuang TY, Korkij W, Soltani K, Clayman J, Cook J. Increased frequency of diabetes mellitus in patients with bullous pemphigoid: a case-control study. J Am Acad Dermatol 1984;11(6):1099-102.
Lynfield YL, Green K, Gopal R. Bullous pemphigoid and multiple autoimmune diseases. Alopecia universalis, bullous pemphigoid, hypothyroidism, rheumatoid arthritis, and neutropenia in one patient. J Am Acad Dermatol 1983;9(2):257-61.
Lindelöf B, Islam N, Eklund G, Arfors L. Pemphigoid and cancer. Arch Dermatol 1990;126(1):66-8.
Joly P, Fontaine J, Roujeau JC. The role of topical corticosteroids in bullous pemphigoid in the elderly. Drugs Aging 2005;22(7):571-6.