Can Neutrophil/Lymphocyte Ratio Be Used As A Marker In The Diagnosis Of Bullous Pemphigoid?

Aim: Bullous pemphigoid (BP) is a bullous dermatosis frequently seen in advanced age that is caused by antibodies reacting to antigens in the dermoepidermal junction. It has been reported that as a result of autoantibody-induced inflammation, inflammatory mediators are increased in patient sera and bullae, and that these increased mediators might be related to disease severity. Neutrophil lymphocyte ratio (NLR) is determined by dividing the number of neutrophils by the number of lymphocytes; it is a parameter that has been previously studied in inflammatory diseases such as urticaria, psoriasis, pemphigus vulgaris and cutaneous vasculitis and has been associated with the disease. The present study investigated the utility of NLR, the marker of systemic inflammation, as a marker in patients with BP. Patients and Methods: Medical records of patients diagnosed with BP between January 2013 and December 2017 were reviewed. By evaluating the laboratory results in their files, the mean platelet volume (MPV), neutrophil count, lymphocyte count, and neutrophil lymphocyte ratio calculated by dividing the number of neutrophils by the number of lymphocytes were recorded. Results: The study included 26 patients with BP and 25 control patients. Neutrophil count (P = 0.005) and NLR (P = 0.04) were found to be higher in patients with BP compared with the control group. No difference was found in lymphocyte count and MPV between the groups. Conclusion: To our knowledge, this is the first study to investigate NLR in patients with BP in the etiopathogenesis of which inflammation takes a part. We believe that NLR, a parameter that can be easily calculated by a whole blood count for systemic inflammation, can be a marker that can be used in the diagnosis of BP.