Diagnosis of pemphigoid diseases

Itch in elderly due to newly recognized autoimmune diseases pemphigoidWith ageing comes itch, a common and burdensome complaint in elderly people and comparable to chronic pain. Itch in elderly is related to ageing of the skin, and possibly due to the recently identified autoimmune disease nonbullous pemphigoid. The studies in the thesis are focused on diagnosis of this disease, to support early recognition.Pemphigoid is a itching skin blisering disease. However, one in four patients does not have skin blistering, but does have complaints of itch. The disease is associated with ageing and most common in persons above 70 years. With the SSENIOR study, we analyzed the prevalence of itch in nursing home residents, and presence of pemphigoid as the cause of itch. The results showed almost half of the 125 participating nursing home residents had complaints or signs of itch, often of chronic duration and in cases of dementia often not recognized. Half of the participants with moderate to severe itch had pemphigoid, with a total prevalence of 6% and 200-fold higher in this high-risk population compared to the general population. Nonbullous pemphigoid is a newly identified blistering disease without skin blisters and a frequent cause of pruritus in elderly, that is well treatable. Another study in this thesis used the database of the national Center for Blistering Diseases of the UMCG and showed the disease can be identified using blood testing, which enables screening and early recognition in a high-risk population