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581
Non-Bullous Pemphigoid: A Single-Center Retrospective Study
Agata Moar1, Alan Azzolini1, Gianpaolo Tessari1
1Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy.
Dermatology (Basel, Switzerland)
|May 12, 2021
Summary
Non-bullous pemphigoid (NBP) patients experience delayed diagnosis and may have increased cardiovascular risks. Persistent itching in elderly patients warrants investigation for bullous pemphigoid (BP).
Area of Science:
- Dermatology
- Autoimmune Diseases
- Cardiology
Background:
- Bullous pemphigoid (BP) is an autoimmune blistering disease.
- Early BP lesions can mimic other skin conditions like eczema or urticaria, leading to diagnostic challenges.
- Non-bullous pemphigoid (NBP) is a variant where blisters may not appear until later or not at all.
Purpose of the Study:
- To differentiate between typical bullous pemphigoid (BP) and non-bullous pemphigoid (NBP).
- To compare clinical, histological, and comorbidity features of BP and NBP.
- To identify potential risk factors and outcomes associated with NBP.
Main Methods:
- Retrospective analysis of 532 BP patients diagnosed between 2000-2019.
- Categorization into BP (blisters within 3 months) and NBP (blisters after 3 months).
- Comparison of demographic data, clinical presentation, comorbidities, and treatment responses using statistical tests.
Main Results:
- 122 patients were included: 98 with BP and 24 with NBP.
- NBP patients had a significantly longer time to diagnosis (30.4 months vs. 2.9 months).
- NBP patients showed a higher incidence of myocardial infarction (37.5% vs. 10.2%) and were more likely to be on diuretics.
Conclusions:
- NBP is associated with diagnostic delays and a potential increased risk of cardiovascular disease, particularly myocardial infarction.
- Persistent, severe pruritus in elderly individuals should prompt investigation for BP.
- These findings underscore the importance of recognizing diverse presentations of BP for timely diagnosis and management.
