Epidemiological Survey of the Patients with Bullous Pemphigoid Hospitalized in Alzahra Hospital, Isfahan, Iran, during the Years 2006-2015

Abstract

Background: Bullous pemphigoid is one of the most common autoimmune blistering diseases. Incidence of bullous pemphigoid has been estimated 4 new cases per 100000, but new studies show that the incidence rate is increasing. The disease typically happens in the elderly people usually after 70 years. Annual mortality rate for bullous pemphigoid is reported up to 40%. The aim of this study was to evaluate epidemiological features of bullous pemphigoid in center of Iran. Methods: This was a cross-sectional study conducted in Alzahra hospital in Isfahan City. 69 patients with bullous pemphigoid hospitalized during the years 2008-2016 were studied. Findings: 59.45% of the patients were women. The mean and standard deviation of age was 68 ± 13 and 72 ± 14 years in woman and men, respectively (P = 0.01). Mucosal involvement was seen in 55.4%., and the most common underlying disease was hypertension (23.6%). 15.4% of women and 3.7% of men used furosemide, and the most commonly prescribed drugs were antihistamine (98%), antibiotics (97%), and topical (91%) and systemic (88.4%) corticosteroids, respectively. The mean and standard deviation of the dose of prednisolone was 54 ± 12 mg per day. Rise in serum blood sugar was reported in 30% of patients, and 3.6% of men and 15% of women needed intensive care unit (ICU) admission. 42.9% of men and 44.4% of women had relapse after discharge, and 38.64% of patients died during one-year follow-up. Conclusion: It seems that patients with bullous pemphigoid need careful follow up, especially during treatment, and at least for one year, because of their age (> 60), underlying diseases, type of treatment (corticosteroid use), and high mortality and relapsing rates in the first year after diagnosis.

Keywords

• Bullous pemphigoid
• Epidemiology
• Age
• Sex
• Treatment
• Complication