_______________________________________________________________

_______________________________________________________________

Report Information from ProQuest
22 March 2014 04:28
_______________________________________________________________

22 March 2014 ProQuest
Daftar isi
1. 694.5 Bullous pemphigoid............................................................................................................................ 1
22 March 2014 ii ProQuest
Dokumen 1 dari 1

694.5 Bullous pemphigoid
Link dokumen ProQuest
Teks lengkap: Global Incidence And Prevalence
Date Updated: 05/13/2011
US Prevalence
U.S.: The present authors evaluated the clinical, economic, and quality-of-life impacts of 22 leading categories
of skin diseases in the United States. The disease categories identified for this study were selected by an expert
panel of dermatologists to represent broadly the national impact of skin disease based on prevalence, severity,
and other factors. Data were obtained primarily from several nationally representative public and private
databases, including the National Health Interview Survey (NHIS), the National Ambulatory Medical Care
Survey, the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the Surveillance, Epidemiology,
and End Results database of the National Cancer Institute (NCI). Databases produced by the National Center
for Health Statistics were the primary source for disease prevalence and health services use data. Because
these databases do not contain cost information, other data sets, including the Medicare standard analytic file
(SAF), were used to assign economic values to the health resource use values. The prevalence (in millions) of
bullous diseases in the U.S. (2004; all ages) was 0.14. (Journal of the American Academy of Dermatology;
V.55; No.3; 9/06; p490)
International Incidence
WORLDWIDE (WITH FRANCE): The incidence rate of bullous pemphigoid (BP) among the general population
varies from 10 to 25 new cases per million per year. This is not in complete agreement with the current study
(conducted in three university dermatologic centers in France), which yields an incidence of approximately 7
new BP cases per million people annually. Although this incidence of BP is probably somewhat underestimated,
the current estimate of 406 to 436 new cases per year in France is large enough to establish BP as the major
autoimmune subepidermal bullous disease for future therapeutic trials. (Arch Dermatol; V.131; 1/95; p48)
TAIWAN: This study analyzes data from Taiwan's National Health Insurance Research Database (NHIRD)
published by the National Health Research Institute, Taipei, Taiwan. Specifically, the sample includes 1039
patients with a principal diagnosis of bullous pemphigoid (BP) who visited ambulatory care centers between
January 1, 2004, and December 31, 2004. The annual incidence of BP calculated from the study database was
3.4 per 100,000 population, which is consistent with the previously reported incidence rate, ranging from 0.7 to
4.3 per 100,000 per year. (Stroke; V.42; 2/11; p319)
UNITED KINGDOM: The authors carried out a large population-based study in people with bullous pemphigoid
and pemphigus vulgaris to provide robust data on incidence and demographic data in the UK and to resolve the
controversies about mortality from these diseases. The health improvement network is a computerized
longitudinal general practice database with demographic data similar to the general population. Between 1996
and 2006, the authors identified all patients with a diagnosis of bullous pemphigoid or pemphigus vulgaris from
the health improvement network database. In order to exclude prevalent cases, they imposed a lag period of
three months after registration with their general practitioner. They selected a control group of up to four
controls per case, matched randomly by age, sex, and general practice. The cohort included 869 people with
bullous pemphigoid contributing 1993 person-years and 3453 matched controls contributing 9765 person-years.
The median age at first presentation for bullous pemphigoid was 80 years, and 534 (61%) patients were
women. The incidence (per 100,000 person-years) of bullous pemphigoid was reported as follows for selected
variables: males, 3.4; females, 5.1; ages under 50 years, 0.5; ages 50-59 years, 1.5; ages 60-69 years, 3.7;
ages 70-74 years, 9.5; ages 75-79 years, 16.1; ages 80-84 years, 22.7; ages 85-89 years, 38.2; ages 90 and
22 March 2014 Page 1 of 9 ProQuest
older, 46.1; calendar period 1996-1998, 1.3; 1999-2001, 3.7; 2002-2004, 5.9; 2005-2006, 6.6. The crude
incidence of bullous pemphigoid was 4.28 per 100,000 person-years. Incidence increased with age and in later
calendar periods. The increased incidence over calendar time persisted after adjustment for age group and sex.
The estimated increase in the incidence of bullous pemphigoid per increase in calendar year was 17% (rate
ratio 1.17) after adjustment for sex and age group, corresponding to a 4.8-fold increase in incidence over the
11-year period or a crude increase of 5.2-fold during the study. The crude incidence of pemphigus vulgaris was
0.68 per 100,000 person-years. Incidence was higher in women and in older age groups. The authors found
evidence of an estimated 11% increase in incidence per calendar year (incidence rate ratio 1.11 per year). They
saw a slight reduction in incidence in the most recent period from 3.5 in 2002-4 to 2.4 in 2005-6. Applying these
data to the UK population between 2001 and 2005 gave an average of 467 new cases of pemphigus vulgaris a
year. (British Medical Journal; V.337; 2008; p a180)
GERMANY (WITH UK AND SWITZERLAND): A cohort of 94 patients (48 female and 46 male) was recruited
from all patients diagnosed with bullous pemphigoid (BP) from two regions in Germany (Mannheim and Lower
Franconia) between January 1989 and December 1997. The overall age-adjusted incidence of BP was 8.7 per
million men and 4.9 per million women per year. Incidence increased with age. For patients over age 60, it was
20.3 per million per year. The highest risk was found for patients more than 90 years old (297-fold higher than in
patients aged 60 or less). In addition, incidence rates for men and women differed in the higher age strata.
There was a 1.9-fold higher risk of BP in men than in women. Other estimates of the incidence of BP range from
10 per million for Bristol (UK) to 30 newly diagnosed cases per million per year in Geneva, Switzerland.
However, for the UK and Switzerland, these numbers are only quoted as rough estimates. In the present study,
because patients living on the borders of the regions covered by both study centers might have been treated in
neighboring departments, the numbers may be an underestimation of the real incidence of BP in these regions.
As the structure of the European population is shifting toward the aged, BP will become more prevalent in
Europe. (J Am Acad Dermatol; V.41; No.2; Pt.1; 8/99; p266)
U.S. Patient Visit And Discharge Trends
U.S. Hospital Inpatients
Date Updated: 07/25/2010
Notes: Visits under 5,000 per year have a relative standard error of +/-30%.
Legend: A=Primary Diagnosis; B=All Listed Diagnosis; C=Average Stay in Days
U.S. Physician Office Visits
Date Updated: 08/01/2010
Notes: Visits under 846,000 per year have a relative standard error of +/-30%.
Legend: A=Primary Diagnosis; B=All Listed Diagnoses
Years 2004 2005 2006 2007 2008 2009
A 588 734 1,281 2,705 1,902 1,010
B 4,877 7,364 7,936 10,273 5,973 5,837
C 6.6 5.7 6.1 6.2 5.4 5.9
Years 2004 2005 2006 2007 2008 2009
A 39,105 22,032 47,003 80,263 62,783 42,915
B 39,105 22,032 47,003 80,263 62,783 42,915
22 March 2014 Page 2 of 9 ProQuest
Date Updated: 08/01/2010
U.S. Emergency Department Visits
Notes: Visits under 80,000 per year have a relative standard error of +/-30%.
Legend: A=Primary Diagnosis; B=All Listed Diagnoses
Date Updated: 08/01/2010
U.S. Hospital Outpatients
Notes: Visits under 100,000 per year have a relative standard error of +/-30%.
Legend: A=Primary Diagnosis; B=All Listed Diagnoses
DEFINITION(S): (1) Bullous pemphigoid -- a chronic, generally benign disease, most commonly of old age,
characterized by tense nonacantholytic bullae in which serum antibodies are localized to the epidermal
basement membrane, causing detachment of the entire thickness of the epidermis. (2) Acantholysis --
separation of individual epidermal keratinocytes from their neighbor. (3) Bulla(e) -- large blister(s) appearing as
a circumscribed area of separation of the epidermis from the subepidermal structure (subepidermal bulla) or as
a circumscribed area of separation of epidermal cells (intraepidermal bulla) caused by the presence of serum,
or occasionally by an injected substance. (4) Pemphigus -- auto-immune bullous diseases with acantholysis:
pemphigus vulgaris, pemphigus foliaceus, pemphigus erythematosus, or pemphigus vegetans; a nonspecific
term for blistering skin diseases.
Article Review
Citation: Yang Y-W et al; "Increased Risk of Stroke in Patients with Bullous Pemphigoid: A Population-Based
Follow-Up Study." Stroke; V.42; 2/11; p319
Abstract
STUDY DESIGN: The goal of this study is to investigate the risk of stroke in patients with bullous pemphigoid
(BP) compared with unaffected individuals of a similar age, adjusted for underlying comorbidities, using a
randomly selected nationwide population-based sample. This study analyzes data from Taiwan's National
Health Insurance Research Database (NHIRD) published by the National Health Research Institute, Taipei,
Taiwan. This study includes a study group and a comparison group. The study sample was drawn from the
ambulatory care claims database that includes every physician consultation in clinics, primary care facilities,
outpatient departments of hospitals, and emergency departments of hospitals in Taiwan. Specifically, the
sample includes 1039 patients with a principal diagnosis of BP who visited ambulatory care centers between
January 1, 2004, and December 31, 2004. The comparison group was taken from the Longitudinal Health
Insurance Database released by the National Health Research Institute. The mean age for the sampled patients
was 72.5 years.
STROKE RISK (TAIWAN): Of the sample of 2340 patients, 312 patients (13.3%) had strokes during the 3-year
follow-up period, 89 (22.8% of the patients with BP) in the study group and 223 (11.4% of patients without BP)
in the comparison group. Compared with patients without BP, analyses stratified by sex and age revealed that
Years 2004 2005 2006 2007 2008 2009
A * * * * 3,786 *
B * * * * 3,786 *
Years 2004 2005 2006 2007 2008 2009
A * * * * 4,484 *
B * * * * 7,372 *
22 March 2014 Page 3 of 9 ProQuest
the hazard ratio (HR) for stroke for patients with BP was 2.37 times as high within the 3-year follow-up period,
after adjusting for patient's age, sex, hypertension, diabetes, hyperlipidemia, heart failure, atrial fibrillation, and
coronary heart disease.
DISCUSSION: This study shows an approximately 2-fold increase in the incidence of stroke for patients with BP
compared with the comparison group. The risk of stroke associated with BP remained high even after
controlling for traditional cerebrovascular risk factors. In this study, a greater proportion of strokes among
patients with BP relative to control subjects was ischemic in nature (72% versus 61%).
To the authors' knowledge, this is the first population-based study to investigate the risk of stroke in a national
cohort of patients with BP. The annual incidence of BP calculated from the study database was 3.4 per 100,000
population, which is consistent with the previously reported incidence rate, ranging from 0.7 to 4.3 per 100,000
per year. Future studies that include clinical markers of BP severity can clarify the underlying pathomechanisms
between BP and stroke.
Article Review
Citation: Langan SM et al; "A Population-Based Study of Acute Medical Conditions Associated With Bullous
Pemphigoid." British Journal of Dermatology; V.161; 2009; p1149
Abstract
STUDY DESIGN: The present authors assessed the incidence of acute events which could predispose to early
mortality following diagnosis of this disorder in a large population-based cohort. The Health Improvement
Network is a computerized longitudinal general practice database with demographic data similar to the general
population. The version of the Health Improvement Network the authors used contained data from 328 general
practices. Between 1996 and 2006, the authors identified all individuals with diagnoses of bullous pemphigoid
from the Health Improvement Network database. A control group of up to four controls per case was selected.
The study cohort consisted of 868 people with bullous pemphigoid. The median age at presentation for bullous
pemphigoid was 80 years.
PNEUMONIA, PULMONARY EMBOLISM, AND SEPSIS: People with bullous pemphigoid had a rate of
pneumonia of 21 per 1000 person-years and were almost 3 times as likely as matched controls to develop
pneumonia. After adjusting for age, gender and comorbidity, the adjusted rate ratio was 2.94. Although the
absolute rates were not so high for pulmonary embolism (4 per 1000 person-years), a similar 3-fold relative
increase was also seen in the incidence of pulmonary embolism (adjusted rate ratio 3.12) compared with
matched controls. The incidence of sepsis was not increased (adjusted rate ratio 2.02).
DISCUSSION: The authors found an approximately 3-fold increase in the incidence of pneumonia and
pulmonary embolism following a diagnosis of bullous pemphigoid compared with the general population of
similar age and sex.
Article Review
Citation: Bernard P et al; "Risk Factors for Relapse in Patients With Bullous Pemphigoid in Clinical Remission:
A Multicenter, Prospective, Cohort Study." Archives of Dermatology; V.145; No.5; 5/09; p537
Abstract
STUDY DESIGN: To identify clinical or immunologic factors predictive of relapse in bullous pemphigoid (BP)
after cessation of corticosteroid therapy, the authors conducted a prospective, multicenter, cohort study with the
French Bullous Diseases Group. 15 dermatologic centers in France participated in this prospective, cohort
study.
Consecutive patients with BP in clinical remission (i.e., absence of blisters, erosions, or pruritic erythematous
eruption) for at least 3 months under low doses of either topical (i.e., 10 g/wk of clobetasol propionate cream or
the equivalent) or systemic (i.e., less than 7 mg/d of prednisone or the equivalent) corticosteroids in whom this
treatment was stopped were eligible for entry. Exclusion criteria were treatment with immunosuppressive drugs
during the preceding 6 months, age younger than 18 years, concurrent disease requiring long-term
22 March 2014 Page 4 of 9 ProQuest
corticosteroid therapy, pregnancy, and estimated survival less than 6 months.
At baseline (day 0: cessation of therapy), each patient underwent clinical examination and a 4-mm punch biopsy
from the skin of flexural aspect of the arm or thigh was performed for further direct immunofluorescence (IF)
testing. Patients were then systematically followed up after cessation of corticosteroid therapy during at least 12
months to detect a further relapse. Visits were planned on days 90, 180, and 360.
118 patients with BP in clinical remission were included in the study between January 1, 2000, and December
31, 2006. Of these patients, 57 (48.3%) were male. The age distribution ranged from 46 to 97 years. The mean
age at entry in the cohort was 81.0 years (median, 82 years).
RELAPSE: Among the 118 patients, 11 (9.3%) died within the first year and 11 (9.3%) were lost to follow-up. Of
the 96 who were still followed up 1 year after the cessation of corticosteroid therapy, 45 (47%) remained in
clinical remission and 51 (53%) experienced at least 1 relapse of BP. Most relapses occurred within the first 3
months of the study. The mean interval to relapse was 3.2 months.
In multivariate analysis, the only factor remaining independently predictive of relapse was a high-titer (i.e., 27 or
more IU/ mL) ELISA score on day 0 (odds ratio, 11.00).
DISCUSSION: To the authors' knowledge, this is the first prospective study to assess risk factors of relapse
after cessation of maintenance therapy in patients with BP. High-titer ELISA scores (3 times higher than the
normal cutoff value) at the time of cessation of therapy represent the main factor for predicting the risk of
relapse of BP within the following year.
Article Review
Citation: Parker SRS et al; "Mortality of Bullous Pemphigoid: An Evaluation of 223 Patients and Comparison
With the Mortality in the General Population in the United States." Journal of the American Academy of
Dermatology; V.59; 2008; p582
Abstract
STUDY DESIGN: The present authors determined the 1-, 2-, and 5-year mortality of a large cohort of patients
with bullous pemphigoid (BP) in the U.S. To determine true mortality, the authors compared the mortality of their
cohort of patients with BP with age-matched populations in the U.S. This was a retrospective cohort study.
Approval from the institutional review board of both institutions was obtained before study initiation. Patients
with a new diagnosis of BP between the years 1998 and 2003 were included in the study. Data were collected
through patient/family-member interview and medical records review.
In all, 223 patients with clinically suspected BP who met the diagnostic criteria were identified. 133 (60%) were
female and 90 were male. The median age was 77 years, and the mean age was 75.2 years. The median
length of follow-up for those alive at the end of the analysis was 4 years, and for all individuals included in the
present analysis the median length of follow-up was 2.69 years.
MORTALITY: In this sample of 223 patients with BP in the U.S., the authors found the 1-, 2-, and 5-year
mortality to be 23%, 37%, and 50%, respectively. These mortalities are similar to those reported in previously
published European studies.
DISCUSSION: When comparing the mortality of patients with BP in the present cohort with the age-specific
death rates in the general U.S. population, the authors found no significant increase in mortality. They conclude
that the mortality of patients with BP is more likely related to advanced age and associated medical conditions
than to disease-specific factors.
Article Review
Citation: Langan SM et al; "Bullous Pemphigoid and Pemphigus Vulgaris---Incidence and Mortality in the UK:
Population Based Cohort Study." British Medical Journal; V.337; 2008; p a180
Abstract
STUDY DESIGN: The authors carried out a large population-based study in people with bullous pemphigoid
and pemphigus vulgaris to provide robust data on incidence and demographic data in the UK and to resolve the
22 March 2014 Page 5 of 9 ProQuest
controversies about mortality from these diseases. The health improvement network is a computerized
longitudinal general practice database with demographic data similar to the general population. Between 1996
and 2006, the authors identified all patients with a diagnosis of bullous pemphigoid or pemphigus vulgaris from
the health improvement network database. In order to exclude prevalent cases, they imposed a lag period of
three months after registration with their general practitioner. They selected a control group of up to four
controls per case, matched randomly by age, sex, and general practice.
The cohort included 869 people with bullous pemphigoid contributing 1993 person-years and 3453 matched
controls contributing 9765 person-years. The median age at first presentation for bullous pemphigoid was 80
years, and 534 (61%) patients were women.
BULLOUS PEMPHIGOID (UK): The incidence (per 100,000 person-years) of bullous pemphigoid was reported
as follows for selected variables: males, 3.4; females, 5.1; ages under 50 years, 0.5; ages 50-59 years, 1.5;
ages 60-69 years, 3.7; ages 70-74 years, 9.5; ages 75-79 years, 16.1; ages 80-84 years, 22.7; ages 85-89
years, 38.2; ages 90 and older, 46.1; calendar period 1996-1998, 1.3; 1999-2001, 3.7; 2002-2004, 5.9; 2005-
2006, 6.6. The crude incidence of bullous pemphigoid was 4.28 per 100,000 person-years. Incidence increased
with age and in later calendar periods. The increased incidence over calendar time persisted after adjustment
for age group and sex. The estimated increase in the incidence of bullous pemphigoid per increase in calendar
year was 17% (rate ratio 1.17) after adjustment for sex and age group, corresponding to a 4.8-fold increase in
incidence over the 11-year period or a crude increase of 5.2-fold during the study.
MORTALITY: The absolute excess mortality in the bullous pemphigoid cohort was 70 per 1000 person-years.
The 1-year mortality for bullous pemphigoid was 19%. These data correspond to a hazard ratio of 2.11. After
adjustment for age, sex, and calendar period, this increased to 2.29.
PEMPHIGUS VULGARIS: The crude incidence of pemphigus vulgaris was 0.68 per 100,000 person-years.
Incidence was higher in women and in older age groups. The authors found evidence of an estimated 11%
increase in incidence per calendar year (incidence rate ratio 1.11 per year). They saw a slight reduction in
incidence in the most recent period from 3.5 in 2002-4 to 2.4 in 2005-6. Applying these data to the UK
population between 2001 and 2005 gave an average of 467 new cases of pemphigus vulgaris a year.
The absolute excess mortality in the pemphigus vulgaris cohort was 62 per 1000 person-years. The 1-year
mortality for pemphigus vulgaris was 12%, and the corresponding hazard ratio was 2.82.
DISCUSSION: Applying the mortality data to the UK population data gave 1977 deaths in bullous pemphigoid
cases and 221 deaths in pemphigus vulgaris cases (2001-2005). These are much higher figures than the 190
and 36 deaths attributed to these diseases in the Office for National Statistics dataset.
This study shows that rates of bullous pemphigoid seem to be increasing over time. Rates of pemphigus
vulgaris are increasing to a lesser degree despite the facts that both disorders are more common with
increasing age and that the multivariate analysis was adjusted for age.
Article Review
Citation: Bickers DR et al; "The Burden of Skin Diseases: 2004." Journal of the American Academy of
Dermatology; V.55; No.3; 9/06; p490
Abstract
STUDY DESIGN: The present authors evaluated the clinical, economic, and quality-of-life impacts of 22 leading
categories of skin diseases in the United States. The disease categories identified for this study were selected
by an expert panel of dermatologists to represent broadly the national impact of skin disease based on
prevalence, severity, and other factors. Data were obtained primarily from several nationally representative
public and private databases, including the National Health Interview Survey (NHIS), the National Ambulatory
Medical Care Survey, the National Hospital Ambulatory Medical Care Survey (NHAMCS), and the Surveillance,
Epidemiology, and End Results database of the National Cancer Institute (NCI). Databases produced by the
National Center for Health Statistics were the primary source for disease prevalence and health services use
22 March 2014 Page 6 of 9 ProQuest
data. Because these databases do not contain cost information, other data sets, including the Medicare
standard analytic file (SAF), were used to assign economic values to the health resource use values.
Because the purpose of this study was to estimate the national burden of skin disease rather than of diseases
that are treated jointly with or primarily by dermatologists, this report covers certain diseases that are treated
primarily by other specialists. To estimate the burden of skin conditions on quality of life from an economic
perspective, the authors adapted a willingness-to-pay approach to approximate the average amount that a
person with a diagnosed skin condition would be willing to pay for a particular health outcome. In this case, the
outcome was defined as relief from symptoms. These costs are considered separately from indirect costs,
because they do not represent actual expenditures; rather, these intangible costs approximate the intrinsic
effect that these conditions have on overall health and quality of life.
Skin condition categories (and their related ICD-9 codes) covered in this report include acne (cystic and
vulgaris), 706.1; actinic keratosis, 702.0; atopic dermatitis, 691.8; benign neoplasms/keloid, 216, 221.1, 221.2,
222.0, 222.1, 222.4, 701.4; bullous diseases, 277.1, 694.0-694.5, 694.60, 694.61, 694.8, 694.9, 695.1, 705.81,
757.39, 919.2, 919.3; contact dermatitis, 692.0-692.6, 692.81, 692.83, 692.89, 692.9; cutaneous fungal
infections, 110, 111, 112.3, 117.1, 117.2, 117.4; cutaneous lymphoma, 202.1, 202.2; drug eruptions, 693.0,
693.1, 693.8, 693.9; hair and nail disorders, 703.0, 703.8, 703.9, 704; herpes simplex and zoster, 053.0-053.2,
053.7-053.9, 054.0-054.9; human papillomavirus/warts, 078.1, 079.4; lupus erythematosus, 373.34, 695.4,
710.0; melanoma, 172.0-172.9; psoriasis, 696.1; rosacea, 695.3; seborrheic dermatitis, 690.1; seborrheic
keratosis, 702.1; skin cancer (nonmelanoma), 173.0-173.8 184.1-184.4, 187.1-187.3, 232.0-232.9; skin ulcers
and wounds, 250.7, 250.8, 454.0, 454.2, 707.0, 707.1, 707.8, 707.9, 896.0-896.3, 897.0-897.7, 879.8, 879.9,
941-946, 948, 949, 991.0-991.3; solar-radiation damage 692.70-692.77, 692.79; and vitiligo, 374.53, 709.0.
PREVALENCE AND COST: The prevalence (in millions) and costs (in $ millions) of bullous diseases in the U.S.
(2004) was reported as follows: prevalence (all ages), 0.14; direct cost, $197; indirect cost because of lost
productivity, $65; total direct and indirect cost, $262; intangible cost because of quality of life impact, $14.
The direct cost (in $ millions) of bullous diseases by cost component was reported as follows: total, $197;
hospital inpatient, $52; hospital outpatient, $6; hospital emergency department, $8; office visits, $85;
prescription drugs, $45. (Note: Prescription drug costs do not include products classified as specialty
pharmaceuticals, which underestimates prescription drug costs associated with some conditions.)
The indirect cost (in $ millions) of bullous diseases by cost component was reported as follows: total, $65; lost
workday, $19.8; restricted activity days, $13.4; caregiver lost workdays, $10.6; foregone future earnings
because of premature death, $21.6.
Article Review
Citation: Jung M et al; "Increased Risk of Bullous Pemphigoid in Male and Very Old Patients: A Population-
Based Study on Incidence." J Am Acad Dermatol; V.41; No.2; Pt.1; 8/99; p266
Abstract
STUDY DESIGN: This study reports age- and gender-specific incidence rates of bullous pemphigoid (BP)
based on a retrospective cohort of patients from two regions in Germany (Mannheim and Lower Franconia)
comprising a population of 1.7 million inhabitants. The study institutions were the only two dermatology
departments in the defined area. The cohort of 94 patients (48 female and 46 male) was recruited from all
patients diagnosed with BP between January 1989 and December 1997. The mean age was 79.3 years for
women and 76.1 years for men.
INCIDENCE (GERMANY): The overall age-adjusted incidence of BP was 8.7 per million men and 4.9 per million
women per year. Incidence increased with age. For patients over age 60, it was 20.3 per million per year. The
highest risk was found for patients more than 90 years old (297-fold higher than in patients aged 60 or less). In
addition, incidence rates for men and women differed in the higher age strata. There was a 1.9-fold higher risk
of BP in men than in women.
22 March 2014 Page 7 of 9 ProQuest
DISCUSSION: Other estimates of the incidence of BP range from 10 per million for Bristol (UK) to 30 newly
diagnosed cases per million per year in Geneva, Switzerland. However, for the UK and Switzerland, these
numbers are only quoted as rough estimates. In the present study, because patients living on the borders of the
regions covered by both study centers might have been treated in neighboring departments, the numbers may
be an underestimation of the real incidence of BP in these regions. As the structure of the European population
is shifting toward the aged, BP will become more prevalent in Europe.
Article Review
Citation: Bernard P et al; "Incidence and Distribution of Subepidermal Autoimmune Bullous Skin Diseases in
Three French Regions." Arch Dermatol; V.131; 1/95; p48
Abstract
INCIDENCE OF BULLOUS PEMPHIGOID: The incidence rate of bullous pemphigoid (BP) among the general
population varies from 10 to 25 new cases per million per year. This is not in complete agreement with the
current study (conducted in three university dermatologic centers in France), which yields an incidence of
approximately 7 new BP cases per million people annually. Although this incidence of BP is probably somewhat
underestimated, the current estimate of 406 to 436 new cases per year in France is large enough to establish
BP as the major autoimmune subepidermal bullous disease for future therapeutic trials.
Subjek: Skin diseases; Epidemiology; Trends; Medical statistics;
Judul: 694.5 Bullous pemphigoid
Judul publikasi: Incidence and Prevalence Data
Suplemen: 694 Bullous dermatoses
Halaman: 0
Tahun publikasi: 2013
Tanggal publikasi: First Quarter 2013
Tahun: 2013
Penerbit: Timely Data Resources, Inc.
Tempat publikasi: Capitola
Negara publikasi: United States
Subjek publikasi: Medical Sciences
Jenis sumber: Reports
Bahasa publikasi: English
Jenis dokumen: Reports, Statistics
ID dokumen ProQuest: 1267786683
URL Dokumen: http://search.proquest.com/docview/1267786683?accountid=25704
Hak cipta: Copyright Timely Data Resources, Inc. First Quarter 2013
Terakhir diperbarui: 2013-01-09
Basis data: ProQuest Public Health
ProQuest Research Library
_______________________________________________________________
22 March 2014 Page 8 of 9 ProQuest

Hubungi ProQuest
Hak cipta 2014 ProQuest LLC. Semua hak cipta dilindungi. - Syarat dan Ketentuan
22 March 2014 Page 9 of 9 ProQuest