title: Prevalence and clinical features of Thai patients with bullous pemphigoid.
abstract: BACKGROUND
  Bullous pemphigoid (BP) is a rare, subepidermal autoimmune blistering disease. Studies from different regions show discrepancies in clinical features and courses.
  
  
  OBJECTIVE
  To reveal clinical characteristics, investigations and clinical outcomes of Thai patients with BP and to evaluate the association of BP with malignancy, diabetes mellitus and neurologic diseases.
  
  
  METHODS
  Patients diagnosed as BP who had visited the autoimmune skin clinic at Siriraj Hospital between 1991 and 2009 were retrospectively studied.
  
  
  RESULTS
  Fifty-eight patients were enrolled. Mean age of onset was 69.3 years. The female to male ratio was 2.7:1. Fifteen percent of the patients had mucosal involvement and 38.9% showed peripheral blood eosinophilia. The sensitivity of the direct and indirect immunofluorescence test in the diagnosis of BP was 95.7% and 73.5%, respectively. The frequency of diabetes mellitus in BP patients was significantly higher than that in the general population (p < 0.001). BP patients had a significantly higher chance of having neurologic diseases compared with other autoimmune vesiculobullous disease patients (adjusted odd ratios 4, 95% confidence interval 1.2-13.3). Disease control was achieved in 89.7% of the patients. One-year and three-year 6.4% remission rate was and 66.3%, respectively.
  
  
  CONCLUSIONS
  BP usually occurred in the seventh and eighth decade of life and affected females more than males. BP is associated with diabetes mellitus and neurologic diseases. Corticosteroids are the mainstay of the treatment. Two-thirds of patients are likely to be in remission within three years.
authors.affiliation: Department of Dermatology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikkt@mahidol.ac.th
authors.forename: Kanokvalai
authors.initials: K
authors.lastname: Kulthanan
authors.forename: Leena
authors.initials: L
authors.lastname: Chularojanamontri
authors.forename: Papapit
authors.initials: P
authors.lastname: Tuchinda
authors.forename: Wararat
authors.initials: W
authors.lastname: Sirikudta
authors.forename: Samruay
authors.initials: S
authors.lastname: Pinkaew
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology; D009422:Nervous System Diseases / Q000150:complications / Q000453:epidemiology; D010391:Pemphigoid, Bullous / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology*; D011239:Prednisolone / Q000627:therapeutic use; D015995:Prevalence; D016019:Survival Analysis; D013785:Thailand; D016896:Treatment Outcome
chemical_list: D011239:Prednisolone