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Background: Data on the annual incidence of bullous pemphigoid (BP) in the U.K. are scarce., Objectives: To estimate the annual incidence of BP in Grampian Region (North-east Scotland) and to assess the causes of mortality in this cohort of patients., Methods: Details were obtained of all patients with a diagnosis of BP recorded in the database of the Pathology Department, Aberdeen Royal Infirmary between January 1991 and December 2001. Community Health Index population data were obtained from the Grampian Health Board and the annual incidence and age- and sex-specific incidence were calculated. Mortality data were obtained from the Patient Administration System and causes of death obtained from the Office of the Registrar for Births and Deaths for Scotland., Results: Eighty-three patients met criteria for diagnosis of BP. The annual incidence of BP in Grampian region was estimated to be 14 cases per million per year. There was a clear and marked rise in the incidence in patients over the age of 80 years. Forty-eight per cent of patients with BP died within 2 years of diagnosis. The all-cause age-standardized mortality ratio was 576%. When compared with cause-specific mortality in the Grampian population over 60 years of age, respiratory disease accounted for a higher than expected number of deaths in our cohort of patients with BP (odds ratio 5.3, 95% confidence interval 3.0-9.4)., Conclusions: North-east Scotland appears to have a relatively high incidence of BP when compared with incidence rates in continental Europe. The mortality rate in patients with BP is considerable, especially within the first 2 years of diagnosis.

Objective: recent evidence suggests a strong association between socio-economic status and atherosclerosis. However, little information exists on the relationship between socio-economic status, symptomatic carotid disease and rates of carotid endarterectomy (CEA). The aim was to evaluate the Carstair Deprivation Score (CDS) of (1) patients admitted with symptomatic carotid disease, and (2) those undergoing CEA in one health board., Method: the CDS score was determined from the post-codes of all patients admitted with a diagnosis of transient ischaemic attack (TIA) or stroke due to cerebral infarction (ISD 9 codes 433.1, 433.09, 435, 437.1; ICD-10: 165.2, 163, 163.2, G45.1, G45.3, G45.9) between 1st April 1995 and 31st March 2000. Expected and actual rates for each of the CDS (1 to 7) were determined by direct and indirect methods of standardisation allowing for age and sex. A similar analysis was performed for patients undergoing carotid endarterectomy. Results were analysed using the Mantel-Haenszel test. Only first time admissions and CEA were included., Results: 1203 patients were admitted with the main diagnosis of symptomatic carotid disease. The admission rate of symptomatic patients was less than expected in the more affluent group (Carstair 1, p < 0.005) and significantly higher in the most deprived group (Carstair 7, p < 0.001). In comparison 192 patients underwent CEA. There were no differences between the expected and actual rates of CEA in each CDS, but the rates tended to be higher in the most affluent group. Geographical variation was also demonstrated with an increased rate of CEA in those patients living in the cities and a reduced rate in those in the rural communities., Conclusion: patients from deprived socio-economic groups had a higher rate of symptomatic carotid disease, but this was not matched by an increased rate of CEA. This suggests that socio-economic inequalities in the prevalence of symptomatic carotid artery disease and treatment exist.