Prediction of Survival for Patients With Bullous Pemphigoid

Joly, P.; Bénichou, Jacques; Lok, C.; Saïag, Philippe; Tancrède‐Bohin, Emmanuelle; Sassolas, B.; Labeille, B.; Doutre, M.‐S.; Gorin, Isabelle; Pauwels, C.; Chosidow, Olivier; Caux, F.; Estève, É.; Dutronc, Yves; Sigal, Michèle; Prost, Cathérine; Maillard, H.; Guillaume, J C; Roujeau, J C

doi:10.1001/archderm.141.6.691

Cited by 150 publications

(182 citation statements)

References 36 publications

(46 reference statements)

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“…Treatment includes topical and systemic corticosteroids, steroid-sparing immunosuppressants, and tetracycline in combination with niacinamide (Joly 2005).…”

Section: Bullous Pemphigoid (Bp)mentioning

confidence: 99%

Role of Corticosteroids in Oral Lesions

Mehdipour¹,

Zenouz²

2012

State of the Art of Therapeutic Endocrinology

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“…Treatment includes topical and systemic corticosteroids, steroid-sparing immunosuppressants, and tetracycline in combination with niacinamide (Joly 2005).…”

Section: Bullous Pemphigoid (Bp)mentioning

confidence: 99%

Role of Corticosteroids in Oral Lesions

Mehdipour¹,

Zenouz²

2012

State of the Art of Therapeutic Endocrinology

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“…BP'nin mortalite oranı pemfigus vulgarise göre çok daha düşüktür. Mortaliteye katkıda bulunan faktörler, BP'nin daha çok yaşlı kişilerde görülmesi, kadın cinsiyet, genel durum bozukluğu, eşlik eden sistemik hastalıkların varlığı, tedavide yüksek doz kortikosteroidlerin verilmesi ile ilişki olarak bilinmektedir 21,24,26 . Avrupadan, BP'nin bir yıllık mortalite oranlarına yönelik çok çeşitli yayınlar mevcuttur.…”

Section: Introductionunclassified

Büllöz pemfigoidli hastalarda 3 yıllık gözlem: 29 olgu

Ekiz¹,

Şen²,

Rifaioğlu³

et al. 2013

TURKDERM

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ÖzetAmaç: Büllöz pemfigoid (BP) kronik, otoimmun subepidemal büllöz bir hastalıktır. Çalışmamızdaki amaç, son 3 yılda kliniğimizde BP tanısı konulan olguların klinik ve epidemiyolojik özelliklerini belirlemek ve sonuçlarımızı ülkemizdeki ve dünyanın diğer yerlerindeki sonuçlarla karşılaştırmaktır. GereçveYöntem:Ocak 2009 ve Ocak 2013 tarihleri arasında Dermatoloji polikliniğimize başvuran, klinik ve histopatolojik olarak BP tanısı alan hastaların dosyaları retrospektif olarak değerlendirildi. Hastaların yaş, cinsiyet, oral mukoza tutulumu, kaşıntının varlığı, hastalık süresi, tetikleyici faktör bulunup bulunmaması, deri lezyonlarının özellikleri, biyopsi örneklerinin direk immünofloresan (DIF) inceleme sonuçları, tedavide kullanılan ilaçlar, nüks ve eksitus oranları ve saptanabilen ölüm nedenleri gibi klinik ve demografik verileri kaydedildi. Bulgular:Çalışmaya alınan 29 hastanın %48,3'ü kadın, %51,7'i erkekti. Yaş ortalamaları 70,17 yıl iken, ortalama hastalık suresi 15,41 aydı. Oral mukoza tutulumu beş, kaşıntı 24 olguda saptandı. Tetikleyici faktör olarak üç olguda ilaç, bir olguda da malinite belirlendi. DIF inceleme sonuçlarında dermoepidermal bileşkede lineer IgG ve C3 depolanması 12 olguda, C3 depolanması 10 olguda mevcuttu. Hastalara başlangıç tedavisi olarak 11 hastaya topikal kortikosteroid, altı hastaya tetrasiklin and nikotinamid kom-binasyonu, 10 hastaya sistemik kortikosteroid tedavisi verildi. Yedi hastada verilen ilk tedaviden sonra bir yıl içinde nüks meydana geldi. Hastane içi mortalite iki hastada görüldü. Sonuç: Çalışmamızda son 3 yılda kliniğimizde BP tanısı konulan hastalarının klinik ve epidemiyolojik verileri sunulmuştur. İlimiz farklı etnik gruplardan oluşan heterojen bir popülasyon olduğu için, çalışmamızın ülkemizdeki BP ile ilgili epidemiyolojik verilerin oluşturulmasında katkıda bulunacağına inanıyoruz. Ancak bu konuda yapılmış prospektif, daha uzun süreli ve çok merkezli çalışmalara ihtiyaç duyulmaktadır. Sum maryBackgroundandDesign:Bullous pemphigoid (BP) is a chronic, autoimmune, subepidermal blistering skin disease. The aim of this study was to determine the clinico-epidemiological characteristics of patients diagnosed with BP in our clinic and to compare the results with those in other studies in our country and in the world. Materials and Methods:We retrospectively evaluated medical records of patients with BP diagnosed by clinical and histopathological examinations in our clinic from January 2009 to January 2013. We evaluated data on demographic characteristics, age, sex, existence of oral mucosal lesions, association of pruritus, duration of the disease, presence of triggering factors, features of the skin lesions, results of direct immunofluorescence (DIF) investigations, drug intake, recurrence and mortality rates and causes of de-tected mortality in all patients. Results:Of the 29 patients included in the study, %48.3 were female, %51.7 were male. The average age was 70.17 years and the mean duration of the disease was 15.41 months. We detected oral mucosal involvement in...

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“…5 Thus, although BP is not as severe as pemphigus vulgaris, it can be quite serious. Although BP is not common, 6 most family physicians can expect to encounter it, 3 especially if they care for large numbers of elderly patients.…”

Section: Discussionmentioning

confidence: 99%

Bullous Lesions on a Skin Graft Donor Site

Orvis

Ihnatsenka²,

Hatch³

2009

The Journal of the American Board of Family Medicine

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Patients with bullous lesions often present to family physicians. In many cases, the diagnosis is readily apparent based on a focused history and examination. We report a case in which the correct diagnosis, bullous pemphigoid (BP), was obscured by an unusual presentation. Although some lesions were typical of BP, most were clustered on a recent skin graft donor site and some were hemorrhagic. A review of recent family medicine literature revealed one article discussing BP, 1 but neither this article nor 3 dermatology textbooks 2-4 mentioned this presentation. However, further literature review revealed that this presentation is actually well described and fits nicely with current understanding of the etiology of BP. The review also revealed an important recent change in BP management: the emergence of ultra-high-potency topical steroids as a first line therapy. As recently as 6 years ago, oral steroids were the standard approach for treating most BP patients. The following case provides an opportunity to review recent advances in the understanding and management of BP, a condition most family physicians can expect to encounter. 3The discussion also addresses the differential diagnosis of bullous lesions and the need for special punch biopsy specimen media if BP is suspected. Case ReportsA 53-year-old woman presented with painless blisters of several days' duration. One month before she sustained a third-degree burn of the right foot requiring a split-thickness skin graft. Her blisters were disproportionately concentrated on the skin graft donor site (Figure 1) but were also present on the left shin (Figure 2). She denied fever and itching and complained only of chronic foot pain ever since skin graft surgery. She denied applying any topical products to the donor site or her legs and denied any recent change in skin care products. The patient had never experienced a similar blistering episode.Her recent medical history included a hospital admission 2 weeks earlier for aspiration pneumonia. Recovery was uneventful apart from Clostridium difficile colitis caused by piperacillin/tazobactam, which was successfully treated with metronidazole. Medical history included insulin-dependent diabetes, chronic renal insufficiency, coronary artery disease, hypertension, and cerebrovascular accident with mild residual right-sided weakness. Medications included oxycodone/acetaminoiphen; lansoprazole; aspirin; atorvastatin; clopidogrel; metoprolol; venlafaxine; albuterol; gabapentin; insulin; Culturelle (an OTC pro-biotic; Amerifit Brands, Inc., Cromwell, CT); and metronidazole.Vital signs were normal during physical examination. The skin graft donor site contained multiple tense bullae with hemorrhagic contents (Figure 1). Similar bullae with clear fluid were seen on the left anterior shin (Figure 2). The bullae were oval to round in shape, 1.5 to 4 cm in diameter, tense, and painless to the touch. There were no lesions in the oral cavity. Gentle pressure applied to the blisters did not cause them to spread outwards, thus yiel...

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Prediction of Survival for Patients With Bullous Pemphigoid

Cited by 150 publications

References 36 publications

Role of Corticosteroids in Oral Lesions

Role of Corticosteroids in Oral Lesions

Büllöz pemfigoidli hastalarda 3 yıllık gözlem: 29 olgu

Bullous Lesions on a Skin Graft Donor Site

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