Büllöz Pemfigoidde Deri Biyopsisinde Eozinofil Sayısının Prognostik Önemi

Yıl 2025, Cilt: 47 Sayı: 6, 908 - 913, 26.09.2025

Emel Yaldir , Özge Bülbül , Funda Canaz , Evrim Yılmaz , Hilal Kaya Erdoğan

https://doi.org/10.20515/otd.1764292

Öz

Büllöz pemfigoid, en yaygın vezikülobüllöz otoimmün hastalıktır ve hastaların yarısında klinik olarak periferik eozinofili görülür. Bu çalışmada, doku eozinofil sayısı ile periferik eozinofili, mukozal tutulum, hastalık şiddeti ve tedavi yanıtı arasındaki ilişkinin analiz edilmesi amaçlandı. Yetmiş yedi büllöz pemfigoid hastasına ait deri biyopsileri yeniden değerlendirildi. Doku eozinofil sayısına göre hastalar düşük (1–20 eozinofil/BBA) ve yüksek (>20 eozinofil/BBA) eozinofil sayısına sahip olgular olarak sınıflandırıldı. Periferik kan eozinofil sayısı, tedavi yanıtı gibi diğer bilgiler de kaydedildi. Hastaların yaş ortalaması 75,08 yıl (36–95) olup %51,9’u kadındı. Doku eozinofil sayısı 1 ile 167 arasında değişmekteydi ve ortalama 28,79 idi. Hastaların %39’unda periferik eozinofili izlendi. Periferik eozinofili ile doku eozinofil sayısı arasında anlamlı ilişki saptandı (p<0,001). Yüksek periferik eozinofili grubunda hastalık yaygınlığı istatistiksel olarak anlamlı düzeyde daha fazlaydı (p=0,034) ve periferik eozinofilisi olan olgularda tam remisyon oranı daha yüksekti (p=0,027). Doku eozinofil sayısı ile Sedimentasyon, CRP, mukozal tutulum, lezyon şiddeti ve tedavi yanıtı arasında anlamlı bir fark saptanmadı. Doku eozinofil sayısı ile periferik eozinofili yakından ilişkilidir. Periferik eozinofili, hastalık şiddeti ve tedavi yanıtı ile ilişkili bulunurken, doku eozinofil sayısının klinik özelliklerle korelasyonu saptanmadı. Literatürde farklı sonuçlar bildirilmektedir. Yüksek komorbidite ve ileri yaş ile hastalık kontrolünün zorlaşması ve tedavinin standardize edilememesinin bu duruma yol açtığı düşünülmektedir.

Anahtar Kelimeler

Büllöz Pemfigoid , doku eozinofil sayısı , periferik eozinofili , hastalık şiddeti

Prognostic Significance of Skin Eosinophil Counts in Bullous Pemphigoid

Öz

Bullous pemphigoid is the most common vesiculobullous autoimmune disease, and clinically, peripheral eosinophilia is observed in half of the patients. This study aimed to analyze the relationship between tissue eosinophil count and peripheral eosinophilia, mucosal involvement, disease severity, and treatment response. Skin biopsies from seventy-seven patients diagnosed with bullous pemphigoid were re-evaluated. Patients were classified according to tissue eosinophil count as having low (1–20 eosinophils/HPF) or high (>20 eosinophils/HPF) eosinophil counts. Additional data, such as peripheral blood eosinophil count and treatment response, were also recorded. The mean age of the patients was 75.08 years (range: 36–95), and 51.9% were female. Tissue eosinophil counts ranged from 1 to 167, with a mean of 28.79. Peripheral eosinophilia was detected in 39% of the patients. A significant correlation was found between peripheral eosinophilia and tissue eosinophil count (p<0.001). The high peripheral eosinophilia group had significantly more extensive disease (p=0.034), and patients with peripheral eosinophilia had a higher rate of complete remission (p=0.027). No significant association was found between tissue eosinophil count and ESR, CRP, mucosal involvement, lesion severity, or treatment response. Tissue eosinophil count and peripheral eosinophilia are closely related. While peripheral eosinophilia was associated with disease severity and treatment response, tissue eosinophil count was not correlated with clinical features. Different results have been reported in the literature. High comorbidity and advanced age, combined with difficulties in disease control and lack of standardized treatment protocols, are believed to contribute to the variability observed across studies.

Anahtar Kelimeler

Bullous Pemphigoid , tissue eosinophil count , peripheral eosinophilia , severity of disease

Kaynakça

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