Bullous Pemphigoid and Epidemiological Patterns in Northern Greece: Insights from an 8-Year Observational Study

Bullous Pemphigoid and Epidemiological Patterns in Northern Greece: Insights from an 8-Year Observational Study

Authors

  • Athina-Ioanna Daponte Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece https://orcid.org/0000-0002-4733-2585
  • Evangelia Kalloniati Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Parthena Meltzanidou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Maria Giannouli Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Anastasia Tsitlakidou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Valentina Oflidou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Maria Boziou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Aikaterini Kyriakou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Stylianos Charalampidis Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Christina Fotiadou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Anastasia Giannakou Head of Immunology and Histocompatibility Department, ‘Papageorgiou’ General Hospital, Thessaloniki, Greece
  • Alexandros Lampropoulos Laboratory of Medical Biology and Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece
  • Anastasia Trigoni Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
  • Myrto-Georgia Trakatelli Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece https://orcid.org/0000-0002-5275-9196
  • Zoe Apalla Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece https://orcid.org/0000-0002-9255-8196
  • Elisabeth Lazaridou Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece https://orcid.org/0000-0002-4072-3591
  • Aikaterini Patsatsi Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece https://orcid.org/0000-0001-9616-2001

Keywords:

Bullous Pemphigoid, Epidemiology, Northern Greece, Autoimmune Blistering Diseases, dpp-4 Inhibitors

Abstract

Introduction: Bullous pemphigoid (BP) is an autoimmune disorder causing tense blisters on the skin and sometimes mucous membranes, primarily affecting older adults. It results from autoantibodies attacking the epidermal basement membrane. The incidence of BP is rising globally, particularly due to drug-induced cases.

Objectives: This study aims to present epidemiological data on BP patients, response to systemic corticosteroid therapy, relapse rates, need for additional therapy, and overall prognosis.

Methods: This retrospective study includes patients diagnosed with BP and admitted to the Dermatology Department of a referral center in Northern Greece from 2014 to 2022. The registry includes parameters such as gender, age of onset, comorbidities, drug associations, hospitalization, additional immunosuppressive therapy or doxycycline use, time to tapering, and number of relapses.

Results: Among 188 patients (88 females, 100 males; mean age 76), 97% received systemic corticosteroid therapy, while 1.6% were treated with potent topical steroids alone. Doxycycline was administered to 8% of patients, and 11.7% received additional immunosuppressive agents. The most common comorbidity was diabetes mellitus (60.6%). BP was associated with gliptin intake in 36% of cases. Hospitalization was required for 79% of patients, with corticosteroid tapering initiated on average by the 23rd day. Disease recurrence occurred in 34% of cases.

Conclusion: The high incidence rates in older adults and DPP-4 inhibitor users underscore the need for continued vigilance and research. Systemic corticosteroids remain the primary treatment at our Center. Continuous monitoring and refinement of prevention and management strategies are crucial for effectively addressing BP.

Author Biographies

Athina-Ioanna Daponte, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Athina-Ioanna Daponte is a doctor and PhD candidate (MD, PhDc). She is a member of the center of expertise as a resident physician at the 2nd Dermatology Clinic, AUTH. She is involved in the evaluation and treatment of patients with follicular diseases, as well as in current research protocols, clinical trials and publications.

Parthena Meltzanidou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Parthena Meltzanidou is a Biologist MSc, PhDc, Academic Scholar at the 2nd Dermatology Depatment in Papageorgiou Hospital. She is performing molecular biology techniques for the diagnosis of autoimmune bullous diseases and is a study coordinator in multiple clinical trials.

Maria Giannouli, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Maria Giannouli is a member of the center of expertise as a specialist physician at the 2nd Dermatology Clinic, AUTH. She is involved in the evaluation and treatment of patients with bullous diseases, as well as in current research protocols, clinical trials and publications.

Anastasia Tsitlakidou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Anastasia Tsitlakidou is a member of the center of expertise as a specialist physician at the 2nd Dermatology Clinic, AUTH. She is involved in the evaluation and treatment of patients with bullous diseases, as well as in current research protocols, clinical trials and publications.

Valentina Oflidou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Valentina Oflidou is a member of the center of expertise as a specialist physician at the 2nd Dermatology Clinic, AUTH. She is involved in the evaluation and treatment of patients with bullous diseases, as well as in current research protocols, clinical trials and publications.

Maria Boziou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Maria Boziou is a member of the center of expertise as a specialist physician at the 2nd Dermatology Clinic, AUTH. She is involved in the evaluation and treatment of patients with bullous diseases, as well as in current research protocols, clinical trials and publications.

 

Aikaterini Kyriakou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Aikaterini Kyriakou is a member of the center of expertise as a specialist physician at the 2nd Dermatology Clinic, AUTH. She is an academic reader at the Medical School of Aristotle University in Thessaloniki. She is involved in the evaluation and treatment of patients with bullous diseases, as well as in current research protocols, clinical trials and publications.

Stylianos Charalampidis, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Stylianos Charalampidis is a member of the center of expertise as a specialist physician at the 2nd Dermatology Clinic, AUTH. He is involved in the evaluation and treatment of patients with bullous diseases, as well as in current research protocols and publications.

Christina Fotiadou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Christina Fotiadou is an Associate Professor of Dermatology and Venereology at Aristotle University of Thessaloniki.  

Alexandros Lampropoulos, Laboratory of Medical Biology and Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece

Professor, Laboratory of Medical Biology and Genetics, Faculty of Medicine, School of Health Sciences, Aristotle University of Thessaloniki, Greece

Anastasia Trigoni, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Anastasia Trigoni, MD, MSc, PHD (Epimelitria A'- Attending Doctor A') 

Myrto-Georgia Trakatelli, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Professor of Dermatology - Venereology

2nd Department of Dermatology

Zoe Apalla, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Professor of Dermatology - Venereology

2nd Department of Dermatology

Elisabeth Lazaridou, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Head of Department Professor of Dermatology - Venereology

2nd Department of Dermatology

Aikaterini Patsatsi, Second Department of Dermatology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

Aikaterini Patsatsi, MD, MSc, PhD is a Professor of Dermatology and Venereology at the Aristotle University School of Medicine, in Thessaloniki, Greece. She oversees the Autoimmune Skin and Bullous Diseases Outpatient Unit and the Cutaneous Lymphoma Outpatient Unit of the 2nd Dermatology Department of the Aristotle University School of Medicine and the Center of Expertise on Autoimmune Bullous Diseases, located at Papageorgiou General Hospital. Prof Patsatsi was a fellow in Dermatopathology in Dermatologikum, Hamburg and at the Ackerman Academy of Dermatopathology in NY. She was also a visiting Scholar in the Autoimmune Skin Diseases Unit and in the Cutaneous Lymphoma Unit at the Department of Dermatology of the University of Pennsylvania. Her MSc was on Medical Research Methodology and her PhD on the diagnostic procedures of bullous pemphigoid. She is the current co – chair of the EADV Task Force on Autoimmune Bullous Diseases. She has recently initiated the formation of the Greek Bullous Diseases Study Group. Her main research fields include autoimmune bullous diseases, autoimmune skin diseases, cutaneous lymphomas, and inflammatory dermatoses (psoriasis, atopic dermatitis). She has published more than 160 peer-reviewed articles in peer – reviewed journals. She has participated as a principal investigator, as well as a sub-investigator in numerous clinical trials. She has also participated as a co-author in books published in English and Greek literature, and she has lectured at many international and national meetings.

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2025-04-30

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Vol. 15 No. 2 (2025): 2025 Vol 15, No 2 | April

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Copyright (c) 2025 Athina-Ioanna Daponte, Evangelia Kalloniati, Parthena Meltzanidou, Maria Giannouli, Anastasia Tsitlakidou, Valentina Oflidou, Maria Boziou, Aikaterini Kyriakou, Stylianos Charalampidis, Christina Fotiadou, Anastasia Giannakou, Alexandros Lampropoulos, Anastasia Trigoni, Myrto-Georgia Trakatelli, Zoe Apalla, Elisabeth Lazaridou, Aikaterini Patsatsi

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Daponte AI, Kalloniati E, Meltzanidou P, et al. Bullous Pemphigoid and Epidemiological Patterns in Northern Greece: Insights from an 8-Year Observational Study. Dermatol Pract Concept. 2025;15(2):4852 . doi:10.5826/dpc.1502a4852

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