Bullous pemphigoid seen at the National Skin Centre: a 2-year retrospective review

Ann Acad Med Singap. 2002 Mar;31(2):170-4.


Introduction: Bullous pemphigoid (BP) is the most common immunobullous disorder in Western Europe, affecting mainly the elderly. Previous reports have suggested that it is rarer in the Far East. We report on the clinico-epidemiological features of BP seen at our centre.

Materials and methods: This is a 2-year retrospective study of patients seen at the National Skin Centre who were diagnosed to have BP.

Results: Fifty-nine patients were newly diagnosed with BP over a 2-year period between January 1998 and December 1999. The minimum estimated incidence was 7.6 per million population per year, with mean age of onset of 77 years, and a male to female ratio of 1:2. There was a predilection for Chinese but not Indian. Localised disease was found in 34% and mucosal involvement in only 1.7%. Direct immunofluorescence was positive in almost all patients, and 94% of those tested had positive indirect immunofluorescence. 'Roof' pattern was present in 95.8% and 'roof and floor' pattern in 4.2%. Prednisolone was the treatment of choice in most patients (78%). Anti-inflammatory agents were more commonly used than a decade ago (13.5%).

Conclusions: BP is the most common immunobullous disease locally, with an incidence at least equal to that in Western Europe. There was a predilection for ethnic Chinese rather than Indian. Apart from the rarity of mucosal involvement, the clinical features are similar to those of Western nations.

MeSH terms

  • Aged
  • Aged, 80 and over
  • China / ethnology
  • Comorbidity
  • Diabetes Mellitus, Type 2 / epidemiology
  • Female
  • Humans
  • Hypertension / epidemiology
  • Male
  • Middle Aged
  • Pemphigoid, Bullous / diagnosis*
  • Pemphigoid, Bullous / drug therapy
  • Pemphigoid, Bullous / epidemiology
  • Pemphigoid, Bullous / ethnology
  • Singapore / epidemiology