Retrospective Analysis Of48Cases Of Bullous Pemphigoid

OBJECTIVE:To retrospectively analysis the clinical characteristics and the results of laboratory examinations of bullous pemphigoid. Summarized the therapy of patients with various degrees of BP. To explore the better methods for diagnosis and treatment df BP.METHODS:Clinical datas of48patients with BP from May2002to March2014in the department of dermatology,the Second Hospital affiliated to Dalian Medical University were retrospectively analysed. Those patients were divided to mild, moderate and severe according to the extent of skin lesions. We used the SPSS19.0groups of data for analysis.RESULTS:There are28male patients and20female patients in this study, male to female ratio is1.4:1. The onset age was53～96years old, the average age of76.5106±9.03104years old, patients over the age of70accounted for83.33%of the total number of patients. The average age of male patients was77.8148±9.05129years old, The average age of female patients was74.7500±8.92586years old, no statistical difference. Most patients with no obvious cause before onset. The eruption of BP has pleomorphism. Majority patients has tense blisters, bullas on apparently normal skin or on an erythematous plaque. Nikolsky in42patients were negative.46patients had different degrees of pruritus. Many patients has combine other diseases besides BP. in this study,13patients combined cardiovascular system’s diseases and8patients combined nervous system’s diseases. All the48patients had histopathologic examination,42cases had blisters and (or) fracture.25patients had direct immunofluorescence examination, positive rate was88%. System application of glucocorticoid and local external use of glucocorticoid, glucocorticoid combined immune inhibitors, immunoglobulin, etc are main methods for the treatment of BP.CONCLUSION:1. BP primarily affects old people, especially70years old or elder, men and women onset age no statistical difference.2.The clinical manifestations of the BP is diversiform, majority patients has tense blisters, bullas on apparently normal skin or on an erythematous plaque, early symptoms are often atypical. We should pay more attention to the combination of clinical manifestation, histopathological and immune pathology, so we can reduce the misdiagnosis and missed diagnosis.3. Patients with BP often accompanied by one or more complications, diseases of the cardiovascular system and nervous system diseases are most common.4, System application of glucocorticoid and local external use of glucocorticoid, glucocorticoid combined immune inhibitors, immunoglobulin, etc are main methods for the treatment of BP. Some mild patients can choose tripterygium wilfordii combined with minocycline and nicotinamide for treatment. The starting and maximum dose of system application of glucocorticoid are positively correlated with disease severity. The largest dose of glucocorticoid in Mucosal involvement patients is higher.