A retrospective study of 45 ifrst hospitalization cases of bullous pemphigoid

doi:10.11786/sypfbxzz.1674-1293.20150404

Abstract：Objective To summarize the clinical features and therapeutic experience of 45 ifrst hospitalization cases of bullous pemphigoid. Methods To analyze the clinical manifestations, histopathology, direct immunolfuorescence, treatment and complications of ifrst-time hospitalized patients with bullous pemphigoid admitted in department of dermatology, the First Afifliated Hospital of Nanjing Medical University from August 2009 to December 2014. Results Thirty nine of 45 inpatients were the elderly. Almost all the patients showed intense bullae with pruritus. Histopathology revealed subepidermal bulla, and the direct immunolfuorescence showed there were IgG and/or C3 linear deposition at basement membrane zone. Six of 45 patients who against advice were discharged or clinical transferred, and they all had hypoalbuminemia on admission. The other 39 patients were discharged from hospital after recovery or improvement, with total effective rate of 86.67%. Nine of 39 patients were treated with systemic glucocorticoids only. The other 30 patients were treated with glucocorticoids combined with immunosuppressant (methotrexate mainly). The hospital days of glucocorticoids-only group were signiifcantly less than glucocorticoids combined with immunosuppressant group (P<0.05). Incidence of infection was obviously higher in glucocorticoids combined with immunosuppressant group (P<0.05). Conclusions Systemic glucocorticoids therapy is the ifrst choice for hospitalized patients with bullous pemphigoid. Glucocorticoids combined with immunosuppressant could enhance the therapeutic effect, however, the incidence of infection would increase. The risk of hypoalbuminemia should be paid attention to.