Epidemiological Study of Autoimmune Bullous Dermatoses in Northeastern Romania

TL;DR

This study examines the frequency of autoimmune blistering skin diseases in northeastern Romania, finding pemphigus to be the most common.

Contribution

The study provides the first detailed epidemiological data on multiple autoimmune bullous dermatoses in northeastern Romania.

Findings

Pemphigus vulgaris had the highest incidence, with 8.16 cases per 1,000,000 inhabitants.

Bullous pemphigoid primarily affected older females, while pemphigus affected older males.

The incidence of pemphigus in this region is higher than in Western Europe.

Abstract

Background: Autoimmune bullous diseases (ABDs) are a rare but significant group of dermatoses that pose great challenges to the treating dermatologist. ABDs are characterized by the presence of tissue-bound and circulating autoantibodies directed against disease-specific target antigens of the skin. Most epidemiological studies have focused on a single ABD. More than that, there are few data about the incidence and prevalence of autoimmune blistering diseases in Romania. Methods: In this study, between 2015 and 2019, we retrospectively investigated a total of 225 patients with autoimmune bullous diseases from the northeastern region of Romania. The diagnosis was based on the clinical and histo- and immunohistological findings. Results: Pemphigus was the most frequently encountered ABD, with an incidence of 8.16/1,000,000 inhabitants, representing 58.7% (132 cases), followed by 24% cases of bullous pemphigoid (54 cases), 15.4% of patients were diagnosed with dermatitis herpetiformis (37 cases), and 0.9% other subepidermal autoimmune bullous dermatoses. The average age of onset of pemphigus vulgaris was 59.4 years, the majority of patients being male, while the average age of patients diagnosed with bullous pemphigoid was 73.8 years, the majority being female. Conclusions: Pemphigus vulgaris is the most frequently encountered ABDs in the northeast of Romania, with a higher incidence than in Western European countries, and this may be due to specific peculiarities of the geographical area, as well as to a genetic susceptibility of the population in this region.

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