Prodromal bullous pemphigoid

Lamb, Philina M; Abell, Edward; Tharp, Michael D.; Frye, Roy A.; Deng, Jau‐Shyong

doi:10.1111/j.1365-4632.2004.02457.x

Cited by 46 publications

(48 citation statements)

References 38 publications

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“…PBP başlangıçta BP'den farklı bir görünümde olsa da bazen klasik BP bül formasyonu gelişebilir veya hastaların pek çoğunda olduğu gibi bül formasyonu oluşmayabilir. [4][5][6] Prodromal BP klasik BP'nin habercisi mi, yoksa ondan tamamen farklı bir hastalık mıdır bilinmemektedir. Bu soru bazı araştırmalarda gündeme getirilmiştir.…”

Section: Discussionunclassified

“…Lamb ve ark. [4] 53 PBP hastasını içeren retrospektif multisentrik bir çalışmada hastaların demografik, klinik ve histopatolojik özelliklerini incelemişlerdir. Çalışmanın sonucunda PBP gözlenme yaşının ortalama 70.8 yıl, ortalama hastalık süresinin 11.8 ay olduğunu bildirmiş-lerdir.…”

Section: Discussionunclassified

“…Bir çalışmada 1-3 yıl süreyle takip edilen 48 hastadan sadece dört tanesinde ilerleyen dönem-lerde bül formasyonu oluştuğu bildirilmiştir. [4] Bizim hastamızda AKD nedeniyle uyguladığımız sistemik ve topikal kortikosteroid tedavisi oluşabilecek BP lezyonlarının bir ay kadar gecikmesine neden olmuş-tu. Hastamızda yaklaşık iki aylık bir sürenin sonunda klasik BP'de gözlenen eritemli zeminde gergin büller oluştu.…”

Section: Discussionunclassified

“…[4][5][6] Bizim olgumuzdan alınan ikinci biyopsi incelemesinde klasik BP histopatolojik bulguları olan dermoepidermal bileşkede ayrışma, dermal infiltrasyon ve direkt immünfloresan boyamada lineer tarzda IgG birikimi saptandı. Hastamız ikinci biyopsinin alın-dığı bu dönemde BP'nin prodromal dönemini geçir-miş, klasik BP klinik ve histopatolojik bulguları barizleşmişti.…”

Section: Discussionunclassified

“…Daha sonraları PBP ile klasik BP arasındaki klinik ve histopatolojik detaylı ayrımlar yapılmıştır. [4][5][6] Klasik BP'de genellikle eritemli zeminde oluşan gergin büller söz konusu olup mukozal tutulum eşlik edebilir veya etmeyebilir. PBP ise herhangi bir deri bulgusu olmadan sadece generalize bir pruritus, ürtikeryal-eritemli-egzematöz-dishidrotik plaklar, prurigo nodü-…”

Section: Introductionunclassified

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An allergic contact dermatitis developed on a bullous pemphigoid case

Çiçek¹,

İnci²,

Çobanoğlu³

et al. 2012

J Kartal TR

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Section: Discussionunclassified

Section: Introductionunclassified

See 3 more Smart Citations

An allergic contact dermatitis developed on a bullous pemphigoid case

Çiçek¹,

İnci²,

Çobanoğlu³

et al. 2012

J Kartal TR

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Bullous Pemphigoid as Pruritus in the Elderly

et al. 2013

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Association of Bullous Pemphigoid With Dipeptidyl-Peptidase 4 Inhibitors in Patients With Diabetes

2018

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The association of bullous pemphigoid (BP) with the use of dipeptidylpeptidase 4 (DPP-4) inhibitors among patients with diabetes has recently emerged. The risk of developing BP during treatment with new DPP-4 inhibitor agents like linagliptin is yet to be established. The clinical features and the prognostic outcomes of patients with DPP-4 inhibitor-associated BP are yet to be established. OBJECTIVES Primarily to estimate the association between DPP-4 inhibitor exposure and the development of BP, and secondarily to characterize the clinical features and history of patients with DPP-4 inhibitor-associated BP. DESIGN, SETTING, AND PARTICIPANTS A retrospective case-control study of the intake of different DPP-4 inhibitor agents and metformin and occurrence of BP among patients with diabetes in a tertiary care referral center for autoimmune bullous diseases in northern Israel. Included were 82 consecutive patients with diabetes and immunopathologically validated BP diagnosed between January 1, 2011, and December 31, 2017, and 328 age-, sex-, and ethnicity-matched control participants with diabetes but without BP. MAIN OUTCOMES AND MEASURES Patients with diabetes and BP and exposure to DPP-4 inhibitors were followed up for a median of 2.0 years and compared with other patients with diabetes and BP who were not exposed to DPP-4 inhibitors regarding clinical and immunological features, laboratory analyses, treatments, and clinical outcomes. RESULTS Eighty-two patients with BP and 328 age-and sex-matched control participants were enrolled; mean (SD) age, 79.1 (9.1) years; and 44 patients were female (53.7%). Overall, DPP-4 inhibitor intake was associated with a 3-fold increased risk for BP (adjusted odds ratio [OR], 3.2; 95% CI, 1.9-5.4). The adjusted ORs for vildagliptin and linagliptin were 10.7 (95% CI, 5.1-22.4) and 6.7 (95% CI, 2.2-19.7), respectively. The association of DPP-4 inhibitor use with BP was independent of the use of metformin and was stronger among male (OR, 4.46; 95% CI, 2.11-9.40) than female (OR, 1.88; 95%, CI 0.92-3.86) patients and strongest in patients younger than 70 years (OR, 5.59; 95% CI, 1.73-18.01). Patients with DPP-4 inhibitorassociated BP presented with higher mucosal involvement (22.2% vs 6.5%; P = .04) and lower mean (SD) peripheral eosinophil counts (399.8 [508.0] vs 1117.6 [1847.6] cells/μL; P = .01) than those with BP who had not been exposed to DPP-4 inhibitor. Discontinuation of DPP-4 inhibitor treatment was followed by improved clinical outcomes. CONCLUSIONS AND RELEVANCE Vildagliptin and, to a lesser extent, linagliptin are associated with an increased risk of BP. This may partly explain the increasing incidence of BP in Israel. Discontinuation of DPP-4 inhibitor treatment in patients with diabetes should be considered when BP is diagnosed.

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Prodromal bullous pemphigoid

Abstract: Patients with PBP tend to be in their sixth or early seventh decade of life and, on average, the duration of disease is 1 year. The most common presentation of disease is urticaria-like plaques.

Cited by 46 publications

References 38 publications

An allergic contact dermatitis developed on a bullous pemphigoid case

An allergic contact dermatitis developed on a bullous pemphigoid case

Bullous Pemphigoid as Pruritus in the Elderly

Association of Bullous Pemphigoid With Dipeptidyl-Peptidase 4 Inhibitors in Patients With Diabetes

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