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Br J Dermatol. 2009 Nov;161(5):1149-52. doi: 10.1111/j.1365-2133.2009.09350.x. Epub 2009 Jun 11.

A population-based study of acute medical conditions associated with bullous pemphigoid.

Author information

1
Centre of Evidence-based Dermatology, University of Nottingham, Queen's Medical Centre, Nottingham, UK. sinead.langan@nottingham.ac.uk

Abstract

BACKGROUND:

Bullous pemphigoid is associated with poorly understood dramatically increased early mortality rates.

OBJECTIVES:

To assess the incidence of acute events predisposing to early mortality.

METHODS:

Computerized medical records from the Health Improvement Network, a large population-based U.K. general practice database, were used to conduct a cohort analysis. Outcome measures were incidence rates of myocardial infarction, pulmonary embolism, pneumonia and sepsis compared with a matched control population.

RESULTS:

People with bullous pemphigoid were three times as likely to develop pneumonia, adjusted rate ratio 2.94 [95% confidence interval (CI) 2.01-4.31] or pulmonary embolism, adjusted rate ratio 3.12 (95% CI 1.37-7.12) compared with matched controls. No statistically significant increase was seen for myocardial infarction, adjusted rate ratio 1.24 (95% CI 0.66-2.33), or sepsis, adjusted rate ratio 2.02 (95% CI 0.78-5.21).

CONCLUSIONS:

The risk of pulmonary embolism and pneumonia is increased following a diagnosis of bullous pemphigoid. It may be possible to reduce associated mortality through considering prophylaxis with either antithromboembolic measures or antibiotic therapy and vaccination.

[Indexed for MEDLINE]

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