Eosinophil and Monocyte Counts as Hematological Markers for Response to Tetracyclines for Treating Bullous Pemphigoid

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Avcı C., Gürbüz Ö., Akarsu S., Aktan Ş.

TURK DERMATOLOJI DERGISI, vol.18, no.1, pp.16-22, 2024 (ESCI)

  • Publication Type: Article / Article
  • Volume: 18 Issue: 1
  • Publication Date: 2024
  • Doi Number: 10.4274/tjd.galenos.2024.69775
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, CINAHL
  • Page Numbers: pp.16-22
  • Dokuz Eylül University Affiliated: Yes


Aim: Tetracyclines are used in bullous pemphigoid (BP) treatment because of their anti-inflammatory properties. We investigated the effects of tetracyclines

on blood cell counts, which serve as inflammatory markers, in patients with BP.

Materials and Methods: The study included 50 patients with BP who were treated with tetracycline group antibiotics and followed up for an average

duration of 3.1±1.2 months in a university hospital between January 2013 and December 2022. Demographic data, comorbidities, medications, physical

examination findings, treatment responses, and hematological parameters before and after treatment were retrospectively recorded.

Results: The median blood eosinophil count (450 cells μL-1; range: 0-430) and the mean blood monocyte count (660 cells μL-1; range: 300-1100) of the 50

patients with BP were significantly higher than those of the healthy age- and gender-matched Turkish population (P < 0.001; P = 0.01; respectively). At the

end of the follow-up period, 30 patients were in remission, whereas relapses occurred in 20 patients. The eosinophil and monocyte cell count, eosinophilto-

lymphocyte ratio (ELR), and C-reactive protein (CRP) levels in patients who were in remission were significantly lower compared to those pre-treatment

(P = 0.001, P = 0.02, P < 0.001, P = 0.001, respectively). There was no significant difference between the doxycycline and tetracycline treatment groups

regarding the odds of remission after treatment [odds ratio: 2 (95% confidence interval: 0.5-7.3)].

Conclusion: Higher levels of circulating monocytes indicate their role in the pathogenesis of BP. Peripheral eosinophil count, ELR, and monocyte count,

along with CRP, could serve as markers for monitoring the response to tetracyclines and the risk of relapse in patients with BP.

Keywords: Eosinophil and monocyte count, anti-inflammatory effect, bullous pemphigoid, hematological parameters, tetracycline