Epidemiology of acquired bullous diseases in Eastern Croatia: a retrospective prewar to postwar study

The purpose of this study was to evaluate the epidemiology of bullous diseases (BD) in eastern Croatia during a ten-year period (1986-1990/1992-1996), and to estimate the effect of prolonged exposure to traumatic events during the war in Croatia on the prevalence and incidence of acquired BD. The files of all BD patients hospitalized at Department of Dermatology and Venereology, Osijek University Hospital, during the periods from January 1986 to December 1990 and from January 1992 to December 1996 were collected and analyzed with regard to personal data, history of the disease including age, sex and onset of symptoms, clinical diagnosis, laboratory findings, and associated illness. Forty-five patients were newly diagnosed with BD over the ten-year period. During the 1986-1990 period, 19 patients with BD represented 0.89% of 2133 patients admitted to our Department. During the 1992-1996 period, 26 newly diagnosed patients with BD represented 1.27% of 2050 patients treated at our Department. Females were more affected than males. The most common clinical variant was pemphigus vulgaris, occurring frequently in the middle-aged population. All our patients were exposed to prolonged stressful war conditions during the 1992-1996 period, therefore, we speculate that extended emotional stress may have triggered the onset of the disease.