title: Assessment of bullous pemphigoid disease area index during treatment: a prospective study of 30 patients.
abstract: BACKGROUND
  Recently, a consensus Bullous Pemphigoid Disease Area Index (BPDAI) was proposed to measure therapeutic outcomes in bullous pemphigoid (BP).
  
  
  OBJECTIVE
  To compare BPDAI with other clinical parameters of disease activity at baseline and to describe the variations of BPDAI during the initial phase of treatment.
  
  
  METHODS
  Thirty BP patients were included and followed for 1 year. BPDAI was assessed at baseline and on days 30, 90 and 360 by the same investigator. Concomitantly, the number of daily new blisters, the skin surface area of erythematous/eczematous/urticarial plaques and blisters/erosions, total lesion area (TLA), pruritus score and mucosal involvement were recorded.
  
  
  RESULTS
  At baseline, BPDAI was 46.7 ± 25 (mean ± SD); it was well correlated with erythematous/eczematous/urticarial skin surface (r = 0.63), TLA (r = 0.83), number of daily new blisters (r = 0.7; p ≤ 0.0002) and anti-BP180 autoantibodies (r = 0.49; p = 0.006), but not with anti-BP230 autoantibodies. For the 8 patients with severe BP at baseline, the mean BPDAI was 76.5, versus 35.9 for moderate BP (p = 0.0007). A value of 56 was proposed as a cut-off value for severe BP. BPDAI decreased to 11.9 ± 8.7, 10.7 ± 12.7 and 2.5 ± 4.1 on days 30, 90 and 360, respectively.
  
  
  CONCLUSIONS
  BPDAI rapidly decreased during the early treatment stage of BP with variations almost totally conditioned by the skin activity component.
authors.affiliation: Service de Dermatologie, Hôpital Robert Debré, CHU de Reims, Reims, France.
authors.forename: Célia
authors.initials: C
authors.lastname: Lévy-Sitbon
authors.forename: Coralie
authors.initials: C
authors.lastname: Barbe
authors.forename: Julie
authors.initials: J
authors.lastname: Plee
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Goeldel
authors.forename: Frank
authors.initials: F
authors.lastname: Antonicelli
authors.forename: Ziad
authors.initials: Z
authors.lastname: Reguiaï
authors.forename: Damien
authors.initials: D
authors.lastname: Jolly
authors.forename: Florent
authors.initials: F
authors.lastname: Grange
authors.forename: Philippe
authors.initials: P
authors.lastname: Bernard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000032:analysis; D001706:Biopsy; D003879:Dermatologic Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012867:Skin / Q000473:pathology*; D013997:Time Factors
chemical_list: D001323:Autoantibodies; D003879:Dermatologic Agents