Epidemiological and clinical analysis of pemphigoid patients in northeastern Poland in 2000-2005

Background: Epidemiological studies on pemphigoid, the most frequent group of autoimmune bullous diseases, are rare. The aim was to evaluate the incidence of pemphigoid in the Podlaskie voivodship (north-eastern Poland), the prevalence of concomitant diseases and their treatment, and the efficacy and side effects of pemphigoid therapy. Material/Methods: The study included 23 female and 12 male consecutive in-patients of the Department of Dermatology and Venereology, Medical University of Bialystok, between January 2000 and June 2006. Their sociodemographic data, diseases, and treatment before and after pemphigoid onset were analyzed. Diagnosis was confirmed rising direct and/or indirect immunological studies. Results: The annual incidence of pemphigoid was 4.47/million. Sixty percent of the patients lived in rural areas. Their mean age at diagnosis was 68.99 years in women and 67.25 years in men; five female patients were under 53 years. All patients were treated for other diseases prior to pemphigoid onset and the diseases could have been drug-induced in > 30% of cases. Two patients had malignancies prior to pemphigoid onset, and neoplasmas were diagnosed afterwards in three. Prednisolone was a successful treatment in > 60% of patients. Infections and osteoporosis were observed in 34.3% during therapy; one patient had sudden gastric hemorrhage. Seven patients died within the first year. Conclusions: The results confirm that pemphigoid affects mainly elderly people, usually being treated for other disorders; the disease may he more frequent in rural are. In an aging society, the disease is expected to become a more serious therapeutic challenge.