Clinical Features between Young and Elderly Patients with Bullous Pemphigoid: An Age-Matched Case Control Retrospective Study

Background: Bullous pemphigoid (BP) mainly happens in elderly patients but also young patients. As the disease could have an early onset in young individuals, this study aimed to determine the clinical features between young and elderly BP patients. Method: This is a retrospective study on inpatients firstly diagnosed with BP in two university-affiliated hospitals from 1990 to 2019. Clinical manifestations, laboratory examinations, treatment, complications, length of hospital stay (LOHS) and prognosis were compared among the three groups: young patient group (age< 40), middle-aged patient group (40 <= age < 60), and elderly patient group (age >= 60). Results: 192 BP patients were included in total: 14 cases in the young patient group, 38 cases in the middle-aged patient group and 140 cases in the elderly patient group. Among these three groups, there was a significant difference in lesions involving the skin of head (LISH), disease-controlled maximum dosage of corticosteroid (DCMDC) and the complications. The LISH in the young, middle-aged and elderly groups were 9.1%, 22.1% and 68.8% respectively. The results of this study further showed that BP was more likely to involve the head and skin at a higher age (chi(2) = 9.742, p = 0.045). BP patients at different ages require different DCMDC to control the disease progression (chi(2) = 3.427, p = 0.035). Multivariate logistic regression analysis showed that the rate of complications increased along with the age of patients (p = 0.004). Conclusion: Together, the data of this study revealed that patients presented different clinical features of BP among different age groups. Copyright (C) 2021, Taiwan Society of Geriatric Emergency & Critical Care Medicine.