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Invited Commentary | Practice Gaps

Clinical and Immunological Factors Associated With Bullous Pemphigoid Relapse

Jo-David Fine, MD, MPH, FRCP1,2
[+] Author Affiliations
1Division of Dermatology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
2Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, Tennessee
JAMA Dermatol. 2014;150(1):34. doi:10.1001/jamadermatol.2013.8090.
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In this issue of JAMA Dermatology, Fichel and colleagues1 have identified 3 clinical and immunological findings in bullous pemphigoid (BP) predictive of disease relapse within the first year of treatment. A statistically significant increase in the risk for relapse was observed in patients with more extensive cutaneous involvement prior to initiation of treatment, patients with dementia, and patients with an enzyme-linked immunosorbent assay (ELISA) test result showing serum levels of anti-BP180 autoantibodies of 23 U/mL or more on day 150. They also demonstrated a surprisingly high rate of success with the use of high-potency corticosteroids alone, coupled with reduction in measurable BP autoantibody levels.

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