Management of bullous pemphigoid with topical steroids in the clinical practice of a single center: outcome at 6 and 12 months.

Abstract

BACKGROUND:

The efficacy of topical steroids in bullous pemphigoid (BP) was assessed by prospective therapeutic trials. Systemic corticosteroids and immunosuppressant agents are indicated in situations of failure or relapses.

OBJECTIVES:

To report our experience in the management of BP outside therapeutic trials focusing on the outcome of the patients at 6 and 12 months, compliance and follow-up difficulties.

METHODS:

Monocenter retrospective study with collection of clinical, therapeutic and follow-up data after 6 and 12 months.

RESULTS:

Ninety-six patients, mean age 84 years, 65 females, 54% had neurological impairment. The initial dose of clobetasol propionate was 30 g/day, followed by a progressive decrease. In the first 6 months, 14% were lost to follow-up and 17.7% died; 62% were controlled with topical steroids alone, and 25% had adjunctive systemic treatment. Difficulties of compliance were mentioned in 34.4%, without significant difference between controlled and noncontrolled patients. After 12 months, 23% were lost to follow-up and 27.1% died. The mean duration of the treatment was 11.7 ± 8.4 months. After the stop, 18.9% of patients relapsed within 3 months.

CONCLUSION:

We emphasize the frequent recourse to systemic treatments in the first few months, the difficulties of compliance and of follow-up in our day-to-day experience.

• Authors: S Ingen-Housz-Oro, L Valeyrie-Allanore, N Ortonne, J C Roujeau, P Wolkenstein, O Chosidow
• Journal: Dermatology (Basel, Switzerland) (Dermatology) Vol. 222 Issue 2 Pg. 176-9 ( 2011) ISSN: 1421-9832 [Electronic] Switzerland
• PMID: 21447939 (Publication Type: Journal Article)
• Copyright: Copyright © 2011 S. Karger AG, Basel.

Chemical References

• Glucocorticoids
• Immunosuppressive Agents
• Clobetasol
• Mycophenolic Acid
• Methotrexate

Topics

• Aged
• Aged, 80 and over
• Clobetasol (therapeutic use)
• Female
• Glucocorticoids (therapeutic use)
• Humans
• Immunosuppressive Agents (therapeutic use)
• Lost to Follow-Up
• Male
• Methotrexate (therapeutic use)
• Middle Aged
• Mycophenolic Acid (analogs & derivatives, therapeutic use)
• Patient Compliance
• Pemphigoid, Bullous (drug therapy)
• Recurrence
• Retrospective Studies
• Treatment Outcome