Bullous Pemphigoid and Epidemiological Patterns in Northern Greece: Insights from an 8-Year Observational Study

Bullous pemphigoid (BP) is an autoimmune disorder causing tense blisters on the skin and sometimes mucous membranes, primarily affecting older adults. It results from autoantibodies attacking the epidermal basement membrane. The incidence of BP is rising globally, particularly due to drug-induced cases.

This study aimed to present epidemiological data on BP patients, response to systemic corticosteroid therapy, relapse rates, need for additional therapy, and overall prognosis.

This retrospective study included patients diagnosed with BP and admitted to the Dermatology Department of a referral center in northern Greece from 2014 to 2022. The registry included parameters such as sex, age at onset, comorbidities, drug associations, hospitalization, additional immunosuppressive therapy or doxycycline use, time to tapering, and number of relapses.

Among the 188 patients (88 females, 100 males; mean age 76 years), 97% received systemic corticosteroid therapy, while 1.6% were treated with potent topical steroids alone. Doxycycline was administered to 8% of patients, and 11.7% received additional immunosuppressive agents. The most common comorbidity was diabetes mellitus (60.6%). BP was associated with gliptin intake in 36% of cases. Hospitalization was required for 79% of patients with corticosteroid tapering initiated on average by day twenty-three. Disease recurrence occurred in 34% of cases.

The high incidence rates in older adults and DPP-4 inhibitor users underscore the need for continued vigilance and research. Systemic corticosteroids remain the primary treatment at our center. Continuous monitoring and refinement of prevention and management strategies are crucial for effectively addressing BP.