Retrospective Analysis Of 56 Cases Of Bulous Pemphigoid

OBJECTIVE To analyze the clinical features and therapy of patients with various degree of bullous pemphigoid,the objective of the thesis is to improve the therapy of BP.METHODS Clinical data of 56 cases of BP from January 1996 to October 2006 in the Department of Dermatology,Qilu Hospital,Shandong University were retrospectively analyzed.It is illustrated in detail about the age of onset,pathogenesis, patient condition,IgE,histopathology,immunofluorescence,complication,misdiagnosis and therapy.RESULTS 56 patients,31 males and 25 females,were enrolled ,whose average age was 63.53±18.93years old. 56 patients have 6 patients of 20-40 years old(10.72% )and 11 patients of 41-60 years old(19.64%)and 39 patients of more than 60 years old(69.64%). In the patients of less than 60 years old ,there are 1 light patients,8 midrange patients , 9 severe patients. The eruption of BP have pleomorphism. Mucosal lesions occurred in 21.43% of patients. The more patient's condition was severe,the higher ratio of mucosae involved was. All patients were examined by histopathology.Immunopathogenesis was positive in 91.3% patients.Serum IgE was higher than normal in 8/17 severe patients,3/32 midrange patients and in 0/7 light patients.The patients were mainly treated with glucocorticoid or the combination of glucocorticoid with immunosuppressive agents ,blood plasma . The initial doses and maximum glucocorticoid doses needed to control lesions were different noticeably for different degree lesions . CONCLUSION 1. BP primarily affects old people. BP eruption of young people was more severe than that of old people .2. The diagnosis of BP is based on histopathology and immunofluorescence.3. The initial doses and maximum glucocorticoid doses needed to control lesions were increased noticeably ,following BP pathogenetic condition aggravating.4. The more patient's condition was severe.the higher ratio of mucosae involved was.5. Immunosuppressive drugs should be used individually according to patient's condition.6. The patients who could not be controlled by routine treatment and had no contraindication to large dose glucocorticoid. could treat with glucocorticoid stosstherapy.7. Local glucocorticoid treatment was safe and effective to BP.8. IVIG was safety and effective to treat BP.