Mortality and Comorbidity Profiles of Patients with Bullous Pemphigoid in Korea
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초록
Background: Bullous pemphigoid (BP) is a common autoimmune- mediated blistering skin disease that is significantly associated with mortality and morbidity. However, few studies regarding the mortality and comorbidity profiles of BP have been reported in Korea. Objective: To evaluate and compare the mortality, comorbidity profiles, and risk factors between patients with BP who visited our clinic and an age-matched general population of Korea. Methods: We retrospectively evaluated 103 patients diagnosed with BP between 2006 and 2013 at Chonnam National University Hospital in Gwangju, Korea. Results: The 1-year, 2-year, and 5-year mortality rates of the patients were 18.44%, 28.16%, and 42.00%, respectively. The median age was 76 years (range, 41∼96 years). The standardized mortality ratio of patients with BP was 1.83 times that of the age- and sex-matched general population of Korea. Old age at the time of diagnosis, cardiac disease and renal disease were associated with increased 5-year mortality. In addition, the prevalence of diabetes, stroke, dementia, and Parkinson’s disease was higher among BP patients than in the general population. Conclusion: The mortality rate of patients with BP is higher than that of the general Korean population. Korean patients with BP are more likely to have dementia, Parkinson’s disease, diabetes, and stroke. Risk factors for increased 5-year mortality include old age at the time of diagnosis and medical comorbidities, especially cardiac disease and renal disease.
Abstract
Background: Bullous pemphigoid (BP) is a common autoimmune- mediated blistering skin disease that is significantly associated with mortality and morbidity. However, few studies regarding the mortality and comorbidity profiles of BP have been reported in Korea. Objective: To evaluate and compare the mortality, comorbidity profiles, and risk factors between patients with BP who visited our clinic and an age-matched general population of Korea. Methods: We retrospectively evaluated 103 patients diagnosed with BP between 2006 and 2013 at Chonnam National University Hospital in Gwangju, Korea. Results: The 1-year, 2-year, and 5-year mortality rates of the patients were 18.44%, 28.16%, and 42.00%, respectively. The median age was 76 years (range, 41∼96 years). The standardized mortality ratio of patients with BP was 1.83 times that of the age- and sex-matched general population of Korea. Old age at the time of diagnosis, cardiac disease and renal disease were associated with increased 5-year mortality. In addition, the prevalence of diabetes, stroke, dementia, and Parkinson’s disease was higher among BP patients than in the general population. Conclusion: The mortality rate of patients with BP is higher than that of the general Korean population. Korean patients with BP are more likely to have dementia, Parkinson’s disease, diabetes, and stroke. Risk factors for increased 5-year mortality include old age at the time of diagnosis and medical comorbidities, especially cardiac disease and renal disease.
참고문헌 (41)
- Schmidt E, "Pemphigoid diseases", Lancet, 381, pp.320~332 (2013)[DOI]
- Di Zenzo G, "Bullous pemphigoid: physiopathology, clinical features and management", Adv Dermatol, 23, pp.257~288 (2007)[DOI]
- Ahmed AR, "Bullous pemphigoid. Clinical and immunologic follow-up after successful therapy", Arch Dermatol, 113, pp.1043~1046 (1977)[DOI]
- Bernard P, "Survival prognosis in pemphigoid. A cohort analysis of 78 patients", Ann Dermatol Venereol, 122, pp.751~757 (1995)
- Bernard P, "Incidence and distribution of subepidermal autoimmune bullous skin diseases in three French regions. Bullous Diseases French Study Group", Arch Dermatol, 131, pp.48~52 (1995)[DOI]
- Bernard P, "Anti-BP180 autoantibodies as a marker of poor prognosis in bullous pemphigoid: a cohort analysis of 94 elderly patients", Br J Dermatol, 136, pp.694~698 (1997)[DOI]
- Roujeau JC, "High risk of death in elderly patients with extensive bullous pemphigoid", Arch Dermatol, 134, pp.465~469 (1998)[DOI]
- Joly P, "A comparison of oral and topical corticosteroids in patients with bullous pemphigoid", N Engl J Med, 346, pp.321~327 (2002)[DOI]
- Rzany B, "Risk factors for lethal outcome in patients with bullous pemphigoid: low serum albumin level, high dosage of glucocorticosteroids, and old age", Arch Dermatol, 138, pp.903~908 (2002)
- Colbert RL, "Mortality rate of bullous pemphigoid in a US medical center", J Invest Dermatol, 122, pp.1091~1095 (2004)[DOI]
- Bystryn JC, "Why is the mortality of bullous pemphigoid greater in Europe than in the US", J Invest Dermatol, 124, pp.xx~xxi (2005)[DOI]
- Garcia-Doval I, "Sepsis associated with dermatologic hospitalization is not the cause of high mortality of bullous pemphigoid in Europe", J Invest Dermatol, 124, pp.666~667 (2005)[DOI]
- Gudi VS, "Annual incidence and mortality of bullous pemphigoid in the Grampian Region of North-east Scotland", Br J Dermatol, 153, pp.424~427 (2005)[DOI]
- Joly P, "Prediction of survival for patients with bullous pemphigoid: a prospective study", Arch Dermatol, 141, pp.691~698 (2005)
- Langan SM, "Bullous pemphigoid and pemphigus vulgaris--incidence and mortality in the UK: population based cohort study", BMJ, 337, pp.a180~ (2008)[DOI]
- Parker SR, "Mortality of bullous pemphigoid: an evaluation of 223 patients and comparison with the mortality in the general population in the United States", J Am Acad Dermatol, 59, pp.582~588 (2008)[DOI]
- Marazza G, "Incidence of bullous pemphigoid and pemphigus in Switzerland: a 2-year prospective study", Br J Dermatol, 161, pp.861~868 (2009)[DOI]
- Risser J, "Mortality of bullous skin disorders from 1979 through 2002 in the United States", Arch Dermatol, 145, pp.1005~1008 (2009)
- Cortes B, "Mortality of bullous pemphigoid in Switzerland: a prospective study", Br J Dermatol, 165, pp.368~374 (2011)[DOI]
- Cortes B, "Mortality rate in bullous pemphigoid: a retrospective monocentric cohort study", Dermatology, 225, pp.320~325 (2012)[DOI]
- Joly P, "Incidence and mortality of bullous pemphigoid in France", J Invest Dermatol, 132, pp.1998~2004 (2012)[DOI]
- Li J, "Mortality of bullous pemphigoid in China", JAMA Dermatol, 149, pp.106~108 (2013)[DOI]
- Zhang LM, "Treatment and mortality rate of bullous pemphigoid in China: a hospital-based study", Eur J Dermatol, 23, pp.94~98 (2013)
- Bernard P, "Mortality of bullous pemphigoid in Asia: the same as in Europe?", Br J Dermatol, 170, pp.1216~1217 (2014)
- Brick KE, "Incidence of bullous pemphigoid and mortality of patients with bullous pemphigoid in Olmsted County, Minnesota, 1960 through 2009", J Am Acad Dermatol, 71, pp.92~99 (2014)[DOI]
- Cai SC, "Mortality of bullous pemphigoid in Singapore: risk factors and causes of death in 359 patients seen at the National Skin Centre", Br J Dermatol, 170, pp.1319~1326 (2014)[DOI]
- Lee JH, "Mortality of patients with bullous pemphigoid in Korea", J Am Acad Dermatol, 71, pp.676~683 (2014)[DOI]
- Gual A, "Mortality of bullous pemphigoid in the first year after diagnosis: a retrospective study in a Spanish medical centre", J Eur Acad Dermatol Venereol, 28, pp.500~506 (2014)[DOI]
- Serwin AB, "Incidence and mortality of bullous pemphigoid in north-east Poland (Podlaskie Province), 1999-2012: a retrospective bicentric cohort study", Int J Dermatol, 53, pp.e432~e437 (2014)[DOI]
- Forsti AK, "Risk of death in bullous pemphigoid: a retrospective database study in Finland", Acta Derm Venereol, 96, pp.758~761 (2016)
- Ren Z, "Hospitalization, inpatient burden and comorbidities associated with bullous pemphigoid in the U.S.A", Br J Dermatol, 176, pp.87~99 (2017)[DOI]
- Laffitte E, "Bullous pemphigoid antigen 1 isoforms: potential new target autoantigens in multiple sclerosis?", Br J Dermatol, 152, pp.537~540 (2005)[DOI]
- Groves RW, "A homozygous nonsense mutation within the dystonin gene coding for the coiled-coil domain of the epithelial isoform of BPAG1 underlies a new subtype of autosomal recessive epidermolysis bullosa simplex", J Invest Dermatol, 130, pp.1551~1557 (2010)[DOI]
- Chen YJ, "Comorbidity profiles among patients with bullous pemphigoid: a nationwide population-based study", Br J Dermatol, 165, pp.593~599 (2011)[DOI]
- Langan SM, "The relationship between neurological disease and bullous pemphigoid: a populationbased case-control study", J Invest Dermatol, 131, pp.631~636 (2011)[DOI]
- Bastuji-Garin S, "Risk factors for bullous pemphigoid in the elderly: a prospective case-control study", J Invest Dermatol, 131, pp.637~643 (2011)[DOI]
- Cordel N, "Neurological disorders in patients with bullous pemphigoid", Dermatology, 215, pp.187~191 (2007)[DOI]
- Taghipour K, "The association of bullous pemphigoid with cerebrovascular disease and dementia: a case-control study", Arch Dermatol, 146, pp.1251~1254 (2010)
- Jedlickova H, "Bullous pemphigoid and internal diseases-a case-control study", Eur J Dermatol, 20, pp.96~101 (2010)
- Bastuji-Garin S, "Drugs associated with bullous pemphigoid. A case-control study", Arch Dermatol, 132, pp.272~276 (1996)[DOI]
- Lloyd-Lavery A, "The associations between bullous pemphigoid and drug use: a UK case-control study", JAMA Dermatol, 149, pp.58~62 (2013)[DOI]