Defining mild, moderate and severe bullous pemphigoid

Linked article:   Masmoudi et al. Br J Dermatol 2021; 184 :1106–1112. Bullous pemphigoid is a rare chronic disease with blistering and itch. The Bullous Pemphigoid Disease Area Index (BPDAI) is a new scoring system developed to measure bullous pemphigoid activity. The aim of the study was to calculate BPDAI cut‐off values to help define mild, moderate and severe bullous pemphigoid. Establishing these disease activity subgroups will help physicians in the management of patients with the condition. In total, 285 patients with bullous pemphigoid from 50 dermatology departments in Europe participated in the study over a 6‐month period. Mild bullous pemphigoid disease was defined as a score of 19 or less on the BPDAI, moderate disease as a score of 20–56 points and severe disease as a score of 57 or more points. In conclusion, the study confirms that the BPDAI is a robust tool to assess bullous pemphigoid activity accurately, both at diagnosis and during the course of the disease. It could help physicians to tailor treatment to disease activity, thereby providing better management of patients with bullous pemphigoid.