About 17% of patients with bullous pemphigoid (BP) had mucosal involvement, according to the findings of a recent study. Laryngeal involvement was also more common than previously reported, the researchers noted, and affected about 4% of patients.
The retrospective cohort study included 328 patients diagnosed with immunepathologically validated BP at a tertiary care referral center in northern Israel between January 1, 2000 and December 31, 2017 (42.4% were male). Clinical and immunological features, laboratory analyses, and treatment of patients with BP and mucosal involvement were compared with those with BP without mucosal involvement. In addition, the prevalence of mucosal involvement was estimated.
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Overall, 56 patients (17.1%) had mucosal lesions. The most frequently affected mucosal surface was oral mucosa (13.7%), followed by laryngeal (4.9%), and genital (3%) mucosae. Among patients with oral lesions, buccal mucosa (55.6%) and the soft palate (53.3%) were the most involved oral structures.
Patients with mucosal involvement were younger, presented more frequently with extensive disease, had less peripheral eosinophilia, and were treated with higher doses of corticosteroids.
“Clinicians should be aware of the notable prevalence of mucosal involvement in BP, particularly of the previously underestimated laryngeal involvement,” the researchers concluded.
Kridin K, Bergman R. Assessment of the prevalence of mucosal involvement in bullous pemphigoid [Published online January 09, 2019]. JAMA Dermatol. doi:10.1001/jamadermatol.2018.5049