Infectious complications in bullous pemphigoid: an analysis of risk factors

Journal of the American Academy of Dermatology
Yee Wei PhoonHaur Yueh Lee

Abstract

Infections are common in bullous pemphigoid and contribute to significant mortality. We sought to define the spectrum of infectious complications and to identify associated risk factors in a bullous pemphigoid cohort. A retrospective cohort study conducted at an academic medical center. In all, 97 patients were included. Infectious complications occurred in 54 patients (56%) and the median duration from diagnosis to first episode of infection was 3 months. Bacteremia occurred in 14 patients (26%) and 26 of 30 deaths (87%) were attributable to infections. On univariate analysis, significant risk factors include low Karnofsky score (<60) (odds ratio [OR] 3.5, 95% confidence interval [CI] 1.5-8.3; P < .01), high Charlson comorbidity index score (≥6) (OR 2.4, 95% CI 1.1-5.5; P = .04), and dementia (OR 4.9, 95% CI 1.5-15.8; P = .01). On multivariate analysis, low Karnofsky score and dementia remained significant with an OR of 3.3 (95% CI 1.1-10.0; P = .03) and OR of 4.2 (95% CI 1.2-14.7; P = .03), respectively. Limitations include potential selection bias as a result of study design and primary outcome measures focused on significant infections requiring hospitalizations. Minor infections were not included. Identified risk factors f...Continue Reading

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Citations

Feb 8, 2016·Journal of the American Academy of Dermatology·A Razzaque AhmedZachary S Spigelman
Nov 29, 2015·The British Journal of Dermatology·B J BarrickJ S Lehman
Sep 8, 2016·Journal of the European Academy of Dermatology and Venereology : JEADV·Y C LaiW C Lambert
Jan 23, 2016·Annales de dermatologie et de vénéréologie·L Valeyrie-Allanore
May 10, 2017·Journal of the European Academy of Dermatology and Venereology : JEADV·B SimH Y Lee
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Sep 18, 2018·The Journal of Dermatological Treatment·Chika OhataTakekuni Nakama
Aug 6, 2017·Clinical Reviews in Allergy & Immunology·Kyle T AmberLuca Borradori
Mar 30, 2019·Journal of the American Academy of Dermatology·Maxim PolanskyRon Feldman
Sep 30, 2021·The British Journal of Dermatology·H Y Lee

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