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British Association of Dermatologists’ guidelines for the management of bullous pemphigoid 2012
Vanessa A. Venning, Kathy Taghipour, M.F. Mohd Mustapa, A.S. Highet, Gudula Kirtschig, J.R. Hughes, J. McLelland, Andrew J. G. McDonagh et al.. British Journal of Dermatology, 2012-11-02
Topic: Drug trials: efficacy and safety
The overall objective of the guideline is to provide up‐to‐date, evidence‐based recommendations for the management of bullous pemphigoid (BP). It is recognized that under certain conditions it may be necessary to deviate from the guidelines and that the results of future studies may require some of the recommendations herein to be changed. Autoantibodies of IgG type (and less commonly IgA, IgM and IgE) attack components of the adhesion complex of the basement membrane zone (BMZ) and result in subepidermal blistering. Recently it has been shown that BP is associated with neurological disease such as cerebrovascular disease, dementia, Parkinson disease, epilepsy and multiple sclerosis.7–10 These conditions pre‐date BP and hence are considered as risk factors. There are a number of anecdotal case reports suggesting an association between BP and some drugs.11–15 A recent small case series reported BP occurring in five diabetic patients taking an oral hypoglycaemic agent, gliptin (dipeptidyl peptidase‐IV inhibitor), together with metformin.16 To date there are three epidemiological studies on the subject of BP and drugs.8, 17, 18 Two French case–control studies, both by the same author, have described a significant relationship with the use of spironolactone and neuroleptics.8, 17 A recent U.K. case–control study found an association only with furosemide after adjusting for cardiovascular and neurological disease.18 The mechanism by which drugs may induce BP has not been studied. Pruritus alone or associated with erythema and/or urticated plaques may precede formation of bullae by weeks or months; in some cases bullae may not become clinically apparent. If using saline, the biopsy must be processed within 24–48 h;19 with Michel’s medium prompt handling is to be preferred, but a longer delay of up to 2 weeks may still yield results.20 Indirect IF (IIF) is performed on serum, and if this is not obtainable, on blister fluid. Antibodies in BP serum usually detect antigens at the roof of the salt‐split skin. most cases this may to BP from other immunobullous such as and some cases of membrane pemphigoid in both of which are on the of the split skin. recent has as an for some autoimmune bullous diseases. of to both BP180 and BP230 can be with available with the BP180 the BP230 The is an important of the BP180 and is used in BP180 to detect that with disease results using the same were reported in of with The is not available in the U.K. but is a in selected cases and
Key findings
- The overall objective of the guideline is to provide up‐to‐date, evidence‐based recommendations for the management of bullous pemphigoid (BP).
- It is recognized that under certain conditions it may be necessary to deviate from the guidelines and that the results of future studies may require some of the recommendations herein to be changed.
- Autoantibodies of IgG type (and less commonly IgA, IgM and IgE) attack components of the adhesion complex of the basement membrane zone (BMZ) and result in subepidermal blistering.
- Recently it has been shown that BP is associated with neurological disease such as cerebrovascular disease, dementia, Parkinson disease, epilepsy and multiple sclerosis.7–10 These conditions pre‐date BP and hence are considered as risk factors.
- There are a number of anecdotal case reports suggesting an association between BP and some drugs.11–15 A recent small case series reported BP occurring in five diabetic patients taking an oral hypoglycaemic agent, gliptin (dipeptidyl peptidase‐IV inhibitor), together with metformin.16 To date there are three epidemiological studies on the subject of BP and drugs.8, 17, 18 Two French case–control studies, both by the same author, have described a significant relationship with the use of spironolactone and neuroleptics.8, 17 A recent U.K. case–control study found an association only with furosemide after adjusting for cardiovascular and neurological disease.18 The mechanism by which drugs may induce BP has not been studied.
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Study details
- Evidence strengthHigh
How this study scored 47/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 27 of the 58 points we could judge it on, which is 47 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (British Journal of Dermatology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2012 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 23121204) |
| Free to read | 2 / 2 | Free to read |
| Points | 27 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 27 of the 58 points we could judge it on is 47 out of 100. |
| Total | 47 / 100 | — |
What each of these 20 components measures, and what this score is not →
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
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APA 7th
Venning, V. A., Taghipour, K., Mustapa, M. M., Highet, A., Kirtschig, G., Hughes, J., et al. (2012). British Association of Dermatologists’ guidelines for the management of bullous pemphigoid 2012. British Journal of Dermatology. https://doi.org/10.1111/bjd.12072
Vancouver
Venning VA, Taghipour K, Mustapa MM, Highet A, Kirtschig G, Hughes J, et al. British Association of Dermatologists’ guidelines for the management of bullous pemphigoid 2012. British Journal of Dermatology. 2012. doi:10.1111/bjd.12072. PMID: 23121204.
BibTeX
@article{venning2012-23121204,
author = {Venning, Vanessa A. and Taghipour, Kathy and Mustapa, M.F. Mohd and Highet, A.S. and Kirtschig, Gudula and Hughes, J.R. and McLelland, J. and McDonagh, Andrew J. G. and others},
title = {{British Association of Dermatologists’ guidelines for the management of bullous pemphigoid 2012}},
journal = {British Journal of Dermatology},
year = {2012},
doi = {10.1111/bjd.12072},
pmid = {23121204},
url = {https://doi.org/10.1111/bjd.12072}
}
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