Mortality from acquired bullous diseases of skin in Canadian adults 2000–2007

Authors

  • Akerke T. Baibergenova MD, PhD, MPH,

    1. Dermatology Division, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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  • Martin A. Weinstock MD, PhD,

    1. Dermatoepidemiology Unit, VA Medical Center
    2. Department of Dermatology, Rhode Island Hospital
    3. Departments of Dermatology and Community Health, Brown University, Providence, RI, USA
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  • Neil H. Shear MD

    1. Dermatology Division, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
    2. Drug Safety Research Group
    3. Faculty of Medicine and Faculty of Pharmacy at the University of Toronto, ON, Canada
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Akerke Baibergenova, md, phd, mph
University of Toronto Division of Dermatology
Sunnybrook Health Sciences Centre
2075 Bayview Ave, M1-700
Toronto ON, M4N 3M5
Canada
E-mail: akerke_b@yahoo.com

Abstract

Background  Bullous skin diseases are known to be associated with significant morbidity and mortality. There have been no studies on mortality from severe bullous skin diseases in Canada.

Methods  We used mortality data from the Statistics Canada website from 2000 to 2007 for three major bullous skin diseases: bullous pemphigoid; pemphigus; and toxic epidermal necrolysis (TEN). Crude and age-standardized mortality rates were calculated and compared with the corresponding US mortality rates. Linear regression was used to assess time trend and effect of gender and age on mortality rates.

Results  During the period of eight years, there were 115 deaths attributed to pemphigoid, 84 to pemphigus, and 44 to TEN. The crude annual mortality rate was the highest for pemphigoid (0.045 per 100,000), followed by pemphigus (0.033), and TEN (0.017). None of these conditions demonstrated significant time trends in mortality rates over the eight-year period, although a trend towards decreasing pemphigus mortality was observed (P = 0.07). No gender difference in mortality was observed, but advanced age was associated with mortality in all three conditions.

Conclusion  Among bullous skin diseases, pemphigoid is the leading cause of mortality in Canada. This is in contrast to the USA, where TEN is the leading cause of mortality from bullous skin diseases. It is not clear whether differences in healthcare systems explain these findings.

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