Mortality rate in bullous pemphigoid: a retrospective monocentric cohort study

Dermatology. 2012;225(4):320-5. doi: 10.1159/000345625. Epub 2012 Dec 21.

Abstract

Background: Bullous pemphigoid (BP) is the most common autoimmune blistering skin disease and is associated with an increased mortality. The end points of our study were to evaluate the mortality rate in a retrospective cohort of BP patients followed up to 5 years after the diagnosis and to determine prognostics factors.

Methods: All new cases of BP diagnosed between 1990 and 2003 in the University Hospital of Geneva were retrospectively collected. 60 patients were included, 47 (88.6%) of whom were treated with a combination of corticosteroids and chlorambucil.

Results: The 1-year, 2-year and 5-year probabilities of death were 26.7, 37.1 and 60.8%, respectively. Old age, dementia and use of chlorambucil at initial doses of 6 mg/day, but not at lower doses, were associated with poor prognosis in multivariate analysis.

Conclusion: Our study confirms that BP is associated with a high mortality. The observed mortality rates are however higher than those of previous studies, which is probably related to the inclusion of more debilitated patients.

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents, Alkylating / therapeutic use
  • Cause of Death*
  • Chlorambucil / therapeutic use
  • Cohort Studies
  • Dementia / complications
  • Humans
  • Middle Aged
  • Multivariate Analysis
  • Pemphigoid, Bullous / drug therapy
  • Pemphigoid, Bullous / mortality*
  • Retrospective Studies
  • Switzerland / epidemiology

Substances

  • Adrenal Cortex Hormones
  • Antineoplastic Agents, Alkylating
  • Chlorambucil