ABSTRACT
UNLABELLED: Bullous pemphigoid is the most frequent autoimmune blistering disease. It occurs in the elderly. The cause of this disease is unknown, but cases of bullous pemphigoid have been occasionally attributed to drug therapy. We conducted a multicenter prospective case-control study looking at the drugs used on a long-term basis before the onset of the disease in 116 incident cases of bullous pemphigoid and 216 control patients with malignant or benign skin tumors. RESULTS: Case patients and control patients received many drugs on a long-term basis (mean +/-SD, 4.4+/-3.2 and 4.4+/-2.7 years respectively). Two classes of drugs, neuroleptics and diuretics, were used more frequently by case patients than control patients. Neuroleptics were used by 15.5% of case patients and 8.3% of control patients (adjusted odds ratios; 1.9; 95% confidence interval, 0.95 to 3.8). Diuretics were used by 36.2% of case patients and 24.5% of control patients (adjusted odds ratios, 1.8; 95% confidence interval, 1.1 to 2.9). Among neuroleptics, no specific drug emerged. The association with diuretics was only linked to aldosterone antagonists, which were taken by 12.9% of case patients and 4.6% of control patients (adjusted odds ratios, 3.1; 95% confidence interval, 1.4 to 7.1). CONCLUSIONS: These results suggest that some drug therapies may be a risk factor for bullous pemphigoid. The cause of this association should be further investigated.
Subject(s)
Antipsychotic Agents/adverse effects , Diuretics/adverse effects , Pemphigoid, Bullous/chemically induced , Aged , Autoimmune Diseases/chemically induced , Case-Control Studies , Female , Humans , Male , Mineralocorticoid Receptor Antagonists/adverse effects , Multivariate Analysis , Prospective StudiesABSTRACT
Vitamin A acid has been used for 20 years in the local treatment of acne. In 1986, Kligman published a description of the efficacy of this molecule against skin ageing. In 1987, we began a study which is still in progress. It is intended to confirm the beneficial effects already observed in photosenescence and to demonstrate them by non-invasive methods and by standardized photographs. This study was randomized and carried out under double blind. Each patient acted as her own control. The concentration administered was 0.025 per cent for 6 months and then 0.05 per cent. The patient was followed up every month for 6 months and then every 4 months. The results demonstrated a reduction in the number and depth of the wrinkles and a regression of the pigmented spots. Safety was excellent and all the patients were highly satisfied with the treatment.
