In Austria, the melanoma burden and its potential socio-economic implications are significantly underestimated. Similarities of incidences indicate this could affect other European countries with well-established CRs and compromise international comparability of data. Austrian regional disparities suggest overdiagnosis of thin melanomas due to the variability of pathologists' thresholds for the diagnosis of early stage tumours.
BackgroundBullous pemphigoid (BP) is the most frequent autoimmune blistering disease mainly affecting elderly patients. Among several published risk factors, a recent post hoc analysis linked anti‐BP180 autoantibodies (AABs) to fatal outcomes in BP. To date, this finding has not been confirmed independently.ObjectiveTo investigate the potential of anti‐BP180‐AAB levels as a marker of prognosis and to identify a cut‐off level indicative of an increased risk for early death. Secondly, to characterize parameters associated with mortality.MethodsRetrospective, single‐centre study of BP patients diagnosed between 2001 and 2012. Analyses included epidemiological and patient‐ and disease‐specific characteristics as well as immunological parameters at diagnosis and during follow‐up. Standardized mortality ratios as well as uni‐ and multivariate regression analyses were calculated.ResultsOne hundred patients (56 women, 44 men) with a median age of 81 years (interquartile range 74–86) were followed up for a median of 775 days (interquartile range 162–1617). One‐year mortality rates were 25.0% implying a 2.4‐fold increased risk of death compared with the general population. High anti‐BP180 autoantibody levels at diagnosis (CI95 1.30–2.89; P = 0.001), dementia (CI95 1.13–6.72; P =0.03), length of hospitalization (CI951.16–2.41; P = 0.01) and age (CI95 1.23–4.19; P = 0.009) correlated significantly with 1‐year mortality. BP180‐AAB concentrations of ≥61 U/mL characterized a subgroup of patients with a particular higher risk for early death compared with the general population (CI95 1.81–3.81; P < 0.0001).ConclusionIn bullous pemphigoid, serum concentrations of BP180 autoantibodies at diagnosis could help to identify patients at risk for death within the first year after diagnosis (cut‐off value 61 U/mL).
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