Failure of initial disease control in bullous pemphigoid: a retrospective study of hospitalized patients in a single tertiary center
N Kremer, T Zeeli, E Sprecher… - International Journal of …, 2017 - Wiley Online Library
N Kremer, T Zeeli, E Sprecher, S Geller
International Journal of Dermatology, 2017•Wiley Online LibraryBackground Bullous pemphigoid (BP) is the most prevalent autoimmune blistering skin
disease in Western countries and in Israel. Initial disease control is achieved in 60–90% of
BP patients within 1–4 weeks of corticosteroid therapy. In the remainder of patients,
recalcitrant disease is controlled with additional immunosuppressive treatment. Objectives
We aimed to evaluate the rate of BP patients who needed adjuvant therapy to achieve initial
disease control and to identify potential predictors for recalcitrant disease. Methods We …
disease in Western countries and in Israel. Initial disease control is achieved in 60–90% of
BP patients within 1–4 weeks of corticosteroid therapy. In the remainder of patients,
recalcitrant disease is controlled with additional immunosuppressive treatment. Objectives
We aimed to evaluate the rate of BP patients who needed adjuvant therapy to achieve initial
disease control and to identify potential predictors for recalcitrant disease. Methods We …
Background
Bullous pemphigoid (BP) is the most prevalent autoimmune blistering skin disease in Western countries and in Israel. Initial disease control is achieved in 60–90% of BP patients within 1–4 weeks of corticosteroid therapy. In the remainder of patients, recalcitrant disease is controlled with additional immunosuppressive treatment.
Objectives
We aimed to evaluate the rate of BP patients who needed adjuvant therapy to achieve initial disease control and to identify potential predictors for recalcitrant disease.
Methods
We conducted a retrospective study of newly diagnosed BP patients who were hospitalized at the Tel Aviv Sourasky Medical Center between the years 2008–2014. We performed statistical analyses to assess the association between clinical factors and failure of initial disease control.
Results
Among 114 hospitalized patients with newly diagnosed BP, 1.8% presented with oral mucosa involvement. Seven patients (6.1%) required systemic agents in addition to corticosteroids to achieve disease control. Hypertension (P = 0.048), involvement of the head region (P = 0.042), and metformin treatment (P = 0.02) were significantly more prevalent among patients with recalcitrant disease.
Conclusions
The low frequency of recalcitrant BP (6.1%) and the rarity of involvement of the oral mucosa (1.8%) in this study suggest that Israeli BP patients present a milder phenotype compared to similar patients from other geographic areas. Hypertension, head involvement, and metformin therapy were found to be significantly associated with the need for adjuvant therapy to achieve initial control, suggesting that these parameters may serve as predictors of treatment response in BP.
Wiley Online Library以上显示的是最相近的搜索结果。 查看全部搜索结果