Bullous pemphigoid: course of the disease. A study of 25 patients

Different studies on the course of bullous pemphigoid have suggested that there may be significant variations in the survival of these patients based on their ethnicity or region of origin. Because of the lack of studies on patients with bullous pemphigoid in the Caribbean, specifically in Puerto Rico, a retrospective analysis about the outcome of patients with this disease in the region was performed. Twenty-five (25) patients were included in this study. The patients were diagnosed as bullous pemphigoid by clinical, histopathologic and immunopathologic assessment. Medical records were reviewed and those patients that were alive were contacted and examined on a follow up visit. Nine were men and sixteen were women; the age at the time of the diagnosis ranged from 54 to 90 year-old (mean 72); 13 were alive after at least 5 years of follow-up and 12 had died. The age at the moment of death ranged from 67 to 95 year-old (mean 83). Of those patients living, 85% were in remission, while 15% had active disease. In general, patients had a disease of mild severity, but, still, 68% of them received systemic corticosteroid therapy. Five of patients had to be admitted due to disease; two of them died while at the hospital. This data suggests that bullous pemphigoid in Puerto Ricans is a disease with a relatively benign course, but which can be fatal in the elderly, especially, if it requires admission to the hospital and the patient receives high doses of systemic corticosteroids.