The most prevalent kind of autoimmune blistering illness is bullous pemphigoid (BP). It has a polymorphic presentation. For a study, researchers sought to determine the various clinical and biochemical BP characteristics.

All BP patients were seen between January 1, 2015, and February 28, 2021 were included in the retrospective 2-center research. They clustered major components using a hierarchical approach.

There were found to be 3 clusters. Patients in cluster 1 (n=155) showed anti-BP230 antibodies in 87% of instances, were older than patients in clusters 2 (n=89) and 3 (n=35; P<.0001), and presented frequently with pauci-bullous BP (n=63 [41%] vs. 14 [16%] and 2 [6%], respectively). About 14 patients (40%) from cluster 3 had more than 100 blisters than 3 (2%) patients from cluster 1 & 0 (0%) patients from cluster 2 (P<.0001). Mucosal involvement was more common in Cluster 3 (n=32 [91%, including epiglottis in 40%] vs 11 [7%] and 34 [38%]; P<.0001). In clusters 2 and 3, antibodies targeting solely BP180 were found in 70% and 74% of patients, respectively. Cluster 3 patients received more systemic treatment and had more relapses.

They discovered 3 separate BP clusters, one of which corresponded to severe BP180+ BP230− BP with mucous membrane pemphigoid characteristics.

Reference: jaad.org/article/S0190-9622(22)00695-8/fulltext