BACKGROUND: Bullous pemphigoid (BP) is an autoimmune bullous disease that mainly affects elderly patients. In this retrospective study, in a series of patients with BP, data on systemic medications were collected in order to investigate a possible association with active BP. METHODS: Thirty-four patients with BP were studied in two groups. Group A contained patients who were receiving systemic medications and group B contained patients receiving no medications. All sera were examined by immunoassay for the possible existence of anti-BP180NC16a and anti-BP230, prior to the initiation of steroid treatment. RESULTS: Patients were of a similar age in both groups (P = 0.07). Anti-BP180NC16a autoantibodies were detected in 80% of patients in group A and in 14% of patients in group B. Anti-BP230 autoantibodies were detected in 25% of patients in group A and in 50% of patients in group B. Levels of circulating anti-BP180NC16a autoantibodies were statistically significantly higher in group A than in group B (P = 0.04). CONCLUSIONS: Patients who were receiving systemic medications seemed to be more susceptible to the development of BP. Should we consider drug exposure as one of the reasons for the increased prevalence of BP in the elderly? It is important to be more vigilant with this category of patients in order to provide an early diagnosis of the disease.
BACKGROUND: Bullous pemphigoid (BP) is an autoimmune bullous disease that mainly affects elderly patients. In this retrospective study, in a series of patients with BP, data on systemic medications were collected in order to investigate a possible association with active BP. METHODS: Thirty-four patients with BP were studied in two groups. Group A contained patients who were receiving systemic medications and group B contained patients receiving no medications. All sera were examined by immunoassay for the possible existence of anti-BP180NC16a and anti-BP230, prior to the initiation of steroid treatment. RESULTS:Patients were of a similar age in both groups (P = 0.07). Anti-BP180NC16a autoantibodies were detected in 80% of patients in group A and in 14% of patients in group B. Anti-BP230 autoantibodies were detected in 25% of patients in group A and in 50% of patients in group B. Levels of circulating anti-BP180NC16a autoantibodies were statistically significantly higher in group A than in group B (P = 0.04). CONCLUSIONS:Patients who were receiving systemic medications seemed to be more susceptible to the development of BP. Should we consider drug exposure as one of the reasons for the increased prevalence of BP in the elderly? It is important to be more vigilant with this category of patients in order to provide an early diagnosis of the disease.