Original paper
Bullous pemphigoid – a retrospective study of the population of patients hospitalized in the Chair and Clinic of Dermatology, Silesian Medical University, and Departments of Dermatology in Silesia

Introduction: Bullous pemphigoid is the most common bullous disease. It affects mainly elderly people; the relative risk of falling ill at the age of 90 is almost 300 times higher than at the age of 60. Bullous pemphigoid can be
a paraneoplastic sign – there are described cases of malignant tumour before, during and after the appearance
of typical bullous skin changes. The number of patients with a malignant internal tumour has been estimated at 15-20%.

Aim: To assess the risk of falling ill in various age groups, methods and results of treatment, coexistence with malignant tumours (paraneoplastic syndrome?) and other diseases, influence of drugs used by patients for aetiology of bullous pemphigoid, and evaluation of prognostic factors such as eosinophilia and albumin level in blood serum.

Material and methods: The study was conducted with retrospective analysis of 235 patients, 142 women and 93 men, average 68.67 ±12.3 years old, hospitalized in the Department of Dermatology, Medical University of Silesia, and 10 dermatology wards in Silesian province in the years 2000-2009.

Results: Prednisone was the most frequently used drug in oral monotherapy (70 patients, 29.7%), then oral corticosteroids with antibiotics or immunosuppressiv/e treatment (107 patients, 45.53%). Therapy effect was evaluated as very good in 139 patients (59.1%), good in 71 patients (30.2%) and satisfactory in 25 patients (10.7%). In 206 patients (87.65%) comorbidities were found, and in 10 patients (4.25%) cancer occurred. Eosinophilia was found in 75 patients (31.9%) and hypoalbuminaemia in 131 patients (55.75%).

Conclusions: This study confirmed that bullous pemphigoid usually occurs after age 65; in patients comorbidities often coexist, with the possibility of some types of cancer among them.