Characterizing the Treatment of Autoimmune Bullous Disorders from 1993 through 2010: a NAMCS Study

Abstract

Autoimmune blistering diseases, though uncommon, are associated with considerable morbidity. There is no established therapeutic ladder for the treatment of blistering disorders. Data from the National Ambulatory Medical Care survey from 1993 to 2010 was analyzed to determine the number of visits for blistering diseases, patient demographics, the specialty of treating physicians, and the most frequently prescribed treatments. Patients with autoimmune blistering disorders were primarily elderly, female, and non-Hispanic white. The majority of patients were managed by dermatologists. There has been no significant change in the number of patients diagnosed with bullous diseases over the observed time period. Oral prednisone was the primary treatment prescribed for patients with both bullous pemphigoid and pemphigus. Though prednisone is the primary medication prescribed for patients with blistering disorders, immunosuppressive therapies are associated with increased morbidity in elderly patients. Alternative therapies should be considered for the treatment of autoimmune bullous disorders when feasible taking into account the associated risks and side effect profile of these medications