Frequency and Correlation of Peripheral and Tissue Eosinophilia with Clinical Manifestations in Patients with Bullous Pemphigoid

Abstract

Introduction: Bullous pemphigoid (BP) is an autoimmune disease involving the sub-epidermal layer. Eosinophilia may play a role in the pathogenesis of BP. Objectives: We aimed to investigate the correlation between dermal or peripheral eosinophilia with clinical presentations in patients with BP. Methods: This cross-sectional study was conducted on 108 BP patients from January 2010 to September 2019. Clinical data were recovered. Skin biopsies were re-evaluated, and the Bullous Pemphigoid Disease Area Index (BPDAI) severity score was calculated. Finally, the relationship between clinical features of BP and dermal or peripheral eosinophilia was analyzed. Results: A total number of 108 patients were included in this study. Thirty-five were excluded due to our exclusion criteria. Finally, data from 73 patients were analyzed. Fifty-seven point five percent of the population was female. There was a significant direct correlation (r = 0.33) between BPDAI severity score and tissue eosinophilia (P = 0.03). No significant relationship was found between BPDAI severity score and peripheral eosinophilia (P = 0.52). There were significant positive correlations between tissue eosinophilia with absolute serum eosinophil count (P = 0.002; r = 0.49) and percentage (P < 0.0001; r = 0.89). Conclusions: This study revealed significant relationships between tissue eosinophilia and BP sever- ity. These findings could be useful in clinical practice. The possible role of eosinophils in BP clinical features should be considered as a promising help for better diagnosis and treatment.