243 Clinical outcomes in COVID-19 patients with varicella zoster virus

Abstract

Pemphigus and Bullous Pemphigoid (BP) are blistering skin diseases that have been increasing in incidence. Determining patient characteristics and medication prescribing patterns for pemphigus and BP can help dermatologists better care for this medically complex population. This study aimed to examine patient characteristics and treatments prescribed at pemphigus and BP visits in the United States. We performed a cross-sectional, population-based analysis using the National Ambulatory Medical Care Survey (NAMCS) database from the years of 1995-2015. During the study years, there were 453,348 (weighted) pemphigus visits. Female patients accounted for the majority (61%). Patients between the ages of 60-69 years accounted for 33% of the visits. Dermatologists conducted 92% of pemphigus visits, and primary care physicians (PCP) conducted 6%. The most common treatments prescribed at pemphigus visits were prednisone (44%), topical corticosteroids (27%), trimethoprim/sulfamethoxazole (13%), and tetracycline (2%). Pemphigus visits were associated with diagnoses such as urinary tract infections (15%), diabetes (15%), and gastroesophageal reflux disease (12%). Additionally, from 1995-2015 there were 1,020,457 (weighted) BP visits. The majority of visits were from females (68%). Individuals 70 years and older accounted for 68% of all BP visits. Dermatologist conducted 96% of BP visits, and PCP did not conduct any visits. The most common treatments prescribed at BP visits were prednisone (32%), topical corticosteroids (22%), methotrexate (6%), minocycline (6%), and doxycycline (5%). BP visits were associated with the diagnosis of hypertension (5%). In conclusion, this study demonstrates that both pemphigus and BP predominantly affect an older population. Notably, oral prednisone was the most commonly prescribed treatment for pemphigus and BP.