Retrospective analysis of morbidity profile of autoimmune bullous diseases in a tertiary care hospital of south tamilnadu- a one year study

Background: Autoimmune bullous diseases are a heterogeneous group of diseases characterized by autoantibodies directed against adhesion proteins. Among these, bullous pemphigoid contributes maximally to the burden followed by pemphigus vulgaris in the global literature while Indian literature substantiates pemphigus vulgaris as the commonest. There is a paucity of data on the prevalence, demographic, regional variation and clinicopathological correlation of various autoimmune bullous diseases from India.We aim to estimate the prevalence and pattern of various autoimmune bullous diseases in patients attending dermatology OPD of Tirunelveli Medical College Hospital and to correlate it with skin biopsy,immunofluorescence study and other investigations. Materials and Methods: This is a retrospective clinical study conducted in the Department of Dermatology, Tirunelveli Medical College in 32 diagnosed autoimmune bullous diseases over a period of one year (January to December 2018). Results: Of the total 32 diagnosed autoimmune bullous disease patients, 19 (59.3%) were pemphigus and 13 (40.6%) were pemphigoid group of diseases (Bullous pemphigoid). Of the 19 pemphigus patients, 13 (40.6%) were pemphigus vulgaris, 4 (12.5%) were pemphigus foliaceous, 1 (3.1%) was pemphigus vegetans and IgA pemphigus each. Both histopathology and direct immunofluorescence were 100% concordant with the clinical diagnosis. Conclusion: Pemphigus vulgaris is the commonest autoimmune bullous disease in India which was confirmed in our study contrasting the world pattern with bullous pemphigoid as the commonest. Larger community-based studies are needed for the epidemiological and clinicoimmunological profile of autoimmune bullous diseases in India which will help in accurate characterisation of autoimmune bullous diseases.