Re-evaluation of the natural course of bullous pemphigoid. A prospective study

Background Few studies of prospectively collected data regarding the natura l course of bullous pemphigoid have been performed. Methods The following factors were combined both quantitatively and qualita tively to obtain results: gender, clinical activity based on the estimation of the body area involvement, disease duration, relapses, coexistence with other disease states, and serology Twenty-seven consecutive patients were followed up for 1 year. Results Most disease activity (85.2%) is exhibited in the first year after onset. There is a lack of parameters with clear predictive significance. Th e extent and severity of skin involvement are equally distributed between t he sexes and not affected by the disease duration. The generalized form of the disease is predominant (86.5%). The average clinical activity in relaps es within the year of follow-up is 48% of the initially observed attack. Th e probability for recurrence is higher in seropositive patients (overall 37 %). Coexistence with other disease states seems to be a random chance event . Conclusions The lack of parameters with predictive importance underlines th e necessity of a thorough follow-up to prevent treatment-related complicati ons in elderly patients.