Patient selection: adult with bullous skin lesions
Parameters:
(1) age in years
(2) atrophic scars
(3) involvement of head and neck
(4) involvement of mucosa
|
Parameter
|
Finding
|
Points
|
|
age in years
|
<= 70 years
|
0
|
|
|
> 70 years
|
1
|
|
atropic scars
|
no
|
1
|
|
|
yes
|
0
|
|
involvement of head and neck
|
no
|
1
|
|
|
yes
|
0
|
|
mucosal involvement
|
no
|
1
|
|
|
yes
|
0
|
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• A score >= 3 is associated with bullous pemphigoid.
Performance:
• At a cutoff of >= 3 the sensitivity was 90% and specificity 83%.
• The positive predictive value was 95%.
Other factors associated with bullous pemphigoid identified:
(1) erythematous plaques
(2) absence of milia
(3) hypereosinophilia (absolute eosinophil count > 500 per µL)
(4) serum anti-BMZ antibodies
(5) absence of mechanical blisters
