A Retrospective Study of Patient-Reported Data of Bullous Pemphigoid and Mucous Membrane Pemphigoid From a US-Based Registry

Front Immunol. 2019 Sep 20;10:2219. doi: 10.3389/fimmu.2019.02219. eCollection 2019.


Bullous pemphigoid (BP) and mucous membrane pemphigoid (MMP) are rare chronic autoimmune disorders characterized by subepidermal blistering. For the United States, there is a limited amount of studies in BP and MMP that address disease demographics and clinical data. In order to more comprehensively examine disease demographics and clinical factors, we performed a retrospective analysis of patient-reported data of 138 BP and 165 MMP patients enrolled in the International Pemphigus & Pemphigoid Foundation (IPPF) disease registry from 2010-2016. Patient-reported data was compared to Physician/Investigator reported data generated in our own local patient population (Western New York; 19 BP and 43 MMP patients). We confirm a female predominance in BP (M:F ratio 1:2.1) and MMP (M:F ratio 1:4.3), and a late onset within the 6th decade of life (average age at diagnosis, 59.1 ± 17.5 years for BP and 54.8 ± 11.2 years for MMP). MMP patients were significantly more likely to have a delay in diagnosis >12 months than BP patients (38 vs. 21%, respectively). Similar to other autoimmune conditions, a large number of BP (34%) and MMP (35%) patients present with other co-existing autoimmune disorders, with the most common being thyroid disease for both groups. Increased illness activity was paralleled by an increase in severe limitations of daily activities. The vast majority of of both BP and MMP patients received high intensity immunosuppression (49%). However, the majority of BP patients reported therapy with prednisone combined with other immunosuppressants (40%), while the majority of MMP patients received immunosuppressants other than prednisone (55%). With the exception of age at diagnosis, the clinical and demographic findings from both the national and local datasets were largely consistent with each other, and support those reported in other countries.

Keywords: autoimmune comorbidity; bullous pemphigoid; cicatricial pemphigoid; clinical characteristics; mucous membrane pemphigoid; ocular cicatricial pemphigoid.

MeSH terms

  • Aged
  • Autoantibodies / immunology
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / immunology
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Mucous Membrane / drug effects
  • Mucous Membrane / immunology
  • Patient Reported Outcome Measures
  • Pemphigoid, Benign Mucous Membrane / drug therapy*
  • Pemphigoid, Benign Mucous Membrane / immunology
  • Pemphigoid, Bullous / drug therapy*
  • Pemphigoid, Bullous / immunology
  • Prednisone / therapeutic use
  • Registries
  • Retrospective Studies


  • Autoantibodies
  • Immunosuppressive Agents
  • Prednisone