Epidemiology, diagnostic reliability and prognostic factors of pemphigoid diseases in Finland
Thesis event information
Date and time of the thesis defence
Place of the thesis defence
Oulu University Hospital, Auditorium 10 ( Kajaanintie 50, Entrance S)
Topic of the dissertation
Epidemiology, diagnostic reliability and prognostic factors of pemphigoid diseases in Finland
Doctoral candidate
Licentiate of Medicine Päivi Leisti
Faculty and unit
University of Oulu Graduate School, Faculty of Medicine, Research Unit of Clinical Medicine
Subject of study
Medicine
Opponent
Professor Teea Salmi, University of Tampere/Tampere University Hospital
Custos
Professor Kaisa Tasanen, University of Oulu/Oulu University Hospital
Occurrence, Comorbid Conditions, Diagnostic Reliability and Prognostic Factors of Pemphigoid diseases in Finland
Bullous pemphigoid (BP) is the most common autoimmune skin disease that causes blisters and mostly affects older adults. People with BP have a higher risk of death. While some factors that predict this risk are known, the data are still unclear. Certain diabetes medications called gliptins can increase the risk of developing BP, but it’s not clear how they affect survival in BP patients.
Mucous membrane pemphigoid (MMP) is a rare autoimmune disease that affects the mucous membranes, like the mouth and eyes. Symptoms can range from mild, such as sores in the mouth, to severe, even life-threatening problems. Because it is so rare, we have little large-scale data about it. Both BP and MMP are usually treated with corticosteroids and other medications that suppress the immune system.
In this study, we first checked how reliable the BP diagnosis codes were in real hospital records. A single code was not enough to accurately identify BP patients, but using the code three times—especially when recorded in dermatology clinics—worked much better. We also studied what affects survival in BP. Methotrexate treatment was linked to a lower risk of death. On the other hand, linagliptin use in diabetic patients was linked to higher mortality. Patients whose BP was linked to gliptin use often had fewer of the typical BP antibodies.
For MMP, we looked at related health problems using a large national dataset and compared patients to people without MMP. We found that MMP was linked to several other physical and mental health conditions, but not to cancers in general, after excluding non-melanoma skin cancers.
Overall, the study supports using methotrexate to treat BP. People taking linagliptin at the time of BP diagnosis may have a higher risk of death, but more research is needed to understand why. Doctors should pay attention to other health problems in MMP patients, and more research is needed to see which comes first—the MMP or the other health issues.
Mucous membrane pemphigoid (MMP) is a rare autoimmune disease that affects the mucous membranes, like the mouth and eyes. Symptoms can range from mild, such as sores in the mouth, to severe, even life-threatening problems. Because it is so rare, we have little large-scale data about it. Both BP and MMP are usually treated with corticosteroids and other medications that suppress the immune system.
In this study, we first checked how reliable the BP diagnosis codes were in real hospital records. A single code was not enough to accurately identify BP patients, but using the code three times—especially when recorded in dermatology clinics—worked much better. We also studied what affects survival in BP. Methotrexate treatment was linked to a lower risk of death. On the other hand, linagliptin use in diabetic patients was linked to higher mortality. Patients whose BP was linked to gliptin use often had fewer of the typical BP antibodies.
For MMP, we looked at related health problems using a large national dataset and compared patients to people without MMP. We found that MMP was linked to several other physical and mental health conditions, but not to cancers in general, after excluding non-melanoma skin cancers.
Overall, the study supports using methotrexate to treat BP. People taking linagliptin at the time of BP diagnosis may have a higher risk of death, but more research is needed to understand why. Doctors should pay attention to other health problems in MMP patients, and more research is needed to see which comes first—the MMP or the other health issues.
Created 23.11.2025 | Updated 24.11.2025