Incidence of bullous pemphigoid and mortality of patients with bullous pemphigoid in Olmsted County, Minnesota, 1960 through 2009.
BACKGROUND
Bullous pemphigoid (BP) is an autoimmune blistering disease that is associated with increased mortality.


OBJECTIVE
We sought to determine the incidence and mortality of patients with BP.


METHODS
A total of 87 residents of Olmsted County, Minnesota, were identified who had their first lifetime diagnosis of BP from January 1960 through December 2009. Incidence and mortality were compared with age- and sex-matched control patients from the same geographic area.


RESULTS
The adjusted incidence of BP was 2.4 per 100,000 person-years (95% confidence interval, 1.9-2.9). Incidence of BP increased significantly with age (P < .001) and over time (P = .034). Trend tests indicate increased diagnosis of localized disease (P = .006) may be a contributing factor. Survival observed in the incident BP cohort was significantly poorer than expected (P < .001). Survival was not different among patients with multisite versus localized disease (P = .90).


CONCLUSIONS
Retrospective study design and study population from a small geographic area are limitations.


CONCLUSIONS
Incidence of BP in the United States is comparable with that found in Europe and Asia. The mortality of BP is lower in the United States than Europe, but higher than previous estimates.
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Katherine E
KE
Brick
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Chad H
CH
Weaver
Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota.
Christine M
CM
Lohse
Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota.
Mark R
MR
Pittelkow
Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
Julia S
JS
Lehman
Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota.
Michael J
MJ
Camilleri
Department of Dermatology, Mayo Clinic, Rochester, Minnesota.
Mustafa
M
Al-Hashimi
Department of Dermatology, Mayo Clinic, Rochester, Minnesota; Division of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota. Electronic address: wieland.carilyn@mayo.edu.
Carilyn N
CN
Wieland
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D010391:Pemphigoid, Bullous / Q000453:epidemiology* / Q000401:mortality; D012189:Retrospective Studies; D016019:Survival Analysis
autoimmune blistering disorder; bullous pemphigoid; epidemiology; geriatric; incidence; mortality