The Management of Autoimmune Bullous Skin Disorders in the Era of COVID-19 Pandemic: A Single Center, Retrospective, Cross-sectional Study

Background: Coronavirus disease-2019 (COVID-19), a serious pulmonary illness caused by the highlycontagious novel coronavirus, is a global pandemic. In this retrospective study, we aimed to demonstrate the COVID-19 prevelance and treatment course of the patients with bullous skin disorders. Materials and Methods: A total of 151 patients with bullous skin disorders who admitted toour department between the dates of October 2019-October 2020 were enrolled in this study. The statistical analysis was performed with the SPSS-21. Results: One hundred twenty five patients were taking systemic steroid treatments and 113 patients were under the treatment of adjuvant treatment including azathioprine (AZA), mycophenolate mofetil (MMF) and dapsone. Eighteen patients received a minimum of a twocure rituximab treatment, and 15 patients a minimum of a three-cure intravenous immunoglobulins (IVIG) treatment the year before the start of the pandemic. Only 4 of the 151 patients had a COVID-19 infection history where all of them experienced a mild disease without hospitalization. Conclusion: As there is no consensus as to the immunosuppressive and biological treatments for autoimmune bullous diseases during the COVID-19 pandemic and we think that the maintenance of a systemic steroid treatment does not increase the incidence rate and the severity of the COVID-19 infection. The immunosuppressive agents including AZA and MMF should be discontinued for the COVID-19 infected patients since no data are showing their beneficial effect for the course of COVID-19 up until now. IVIG can be considered as a therapeutic option for the COVID-19-infected autoimmune bullous disease patients. Keywords: Azathioprine, Bullous pemphigoid, Bullous skin disorders, Pemphigus vulgaris