Features of polymorbid pathology in patients with autoimmune bullous dermatosis

Abstract

Autoimmune bullous dermatosis (ABD) is a group of inherited and acquired skin diseases, the main morphological elements of which are the bullas, developed as a result of autoantibody production directed against protein structures of the epidermis and dermo-epidermal junction, leading to epidermal detachment and blistering on the skin and mucous membranes.The aim of the research is to analyze the detection rate and structure of polymorbid pathology in patients with autoimmune bullous dermatoses and to determine the Charlson index and 10-year viability in patients before and after prescription of glucocorticosteroid therapy.Materials and methods. The research included retrospective and prospective stages. At the first stage, the analysis of primary medical records was carried out, and histories of 70 patients over 18 years old, before the onset of autoimmune bullous dermatosis were analyzed. Clinical and epidemiological data were taken into account, the main and concomitant diagnoses were determined in accordance with ICD X. The Charlson index was calculated for all patients, the 10-year viability rate of patients with autoimmune bullous dermatoses was determined.Results. Polymorbid pathology was recorded in 81.4% of patients, before the onset of autoimmune bullousdermatosis. 48.6% of patients had two or more concomitant diseases. Among patients with diseases of internal organs, those with cardiovascular pathology (52.8%) occupied the first place, patients with gastroenteric pathology (41.4%) occupied the second place, patients with endocrinopathy held the third place (20.0%). The Charlson index median in patients of this group was 2.5 (1–3), the risk of fatal outcome over a 10-year period was 16.5%. Subsequently, after the onset of autoimmune bullous dermatosis, 65.7% of patients required the prescription of glucocorticosteroid therapy. Decompensation of concomitant pathology was diagnosed in 39.1% of patients, therefore they needed consultation of related specialists. The median polymorbidity index increased to 3.5 (2–5), the risk of a death increased to 34.5% (p < 0.05).Conclusion. Polymorbid pathology worsens the course of autoimmune bullous dermatoses, increases the risk of disability and mortality, especially in patients receiving systemic glucocorticosteroid therapy, and therefore these patients should be under regular medical check-up not only of a dermatovenereologist, but also of related specialists.

Keywords

• аутоиммунные буллезные дерматозы
• полиморбидность
• индекс чарлсон
• глюкокортикостероиды