title: Current practice in treatment approach for bullous pemphigoid: comparison between national surveys from the Netherlands and the UK.
abstract: Treatment approaches for bullous pemphigoid (BP), the most common autoimmune skin blistering disease, are largely based on national and international guidelines. We conducted a national survey among dermatologists in the Netherlands to explore the current treatment of BP, and compared the results with those of a previously published survey from the UK. Almost all responders in the Netherlands (n = 175) used very potent topical corticosteroids, both as monotherapy and as adjunctive therapy. In contrast to UK dermatologists, the majority recommended whole-body application rather than local application to lesions. Systemic antibiotics were used by > 70% of responders. Half of the responders in the Netherlands considered systemic steroids the first-choice treatment, with the majority also using adjunctive therapy as a routine. Despite many similarities in treatment approach between the two countries, these surveys provide an important insight into the gap between actual and recommended practice at a country level in relation to the best external evidence.
authors.affiliation: Department of Dermatology, Center for Skin Blistering Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: J M
authors.initials: JM
authors.lastname: Meijer
authors.affiliation: Department of Dermatology, Center for Skin Blistering Diseases, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: M F
authors.initials: MF
authors.lastname: Jonkman
authors.affiliation: Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
authors.forename: F
authors.initials: F
authors.lastname: Wojnarowska
authors.affiliation: Center of Evidence Based Dermatology, University of Nottingham, Nottingham, UK.
authors.forename: H C
authors.initials: HC
authors.lastname: Wiliams
authors.affiliation: Institute of General Practice and Professional Care, University Hospital Tübingen, Tübingen, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Kirtschig
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000627:therapeutic use; D003880:Dermatology / Q000706:statistics & numerical data; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D009426:Netherlands; D010391:Pemphigoid, Bullous / Q000188:drug therapy*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D013256:Steroids / Q000627:therapeutic use; D006113:United Kingdom
chemical_list: D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D003879:Dermatologic Agents; D005938:Glucocorticoids; D013256:Steroids