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Pemphigus Vulgaris and Infections: A Retrospective Study on 155 Patients

DOI: 10.1155/2013/834295

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Abstract:

Background. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Aim. We aimed to study the prevalence of infection and pathogenic agents in pemphigus vulgaris patients admitted to dermatology service. Material and methods. This retrospective study was conducted on 155 pemphigus vulgaris patients (68?males, 87?females) admitted to dermatology service between 2009 and 2011. In this study, the diagnosis of pemphigus vulgaris was confirmed by light microscopic and direct immunofluorescence findings. Data were collected through a questionnaire. Results. Of 155?pemphigus vulgaris patients, 33 had infection at admission and 9 acquired nosocomial infection. In addition, 37?cases of oral candidiasis and 15?cases of localized herpes simplex were recorded. Totally, 94?cases of infection were recorded. The occurrence of infection was significantly related to the severity of disease, number of hospital admissions, and presence of diabetes mellitus. The most common pathogenic germs isolated from cultures were Staphylococcus aureus and Escherichia coli. Conclusion. Severity of pemphigus vulgaris and diabetes were directly related with tendency to infections. Staphylococcus aureus and Escherichia coli were the most common pathogenic agents. Due to limitations of retrospective study, a prospective study is recommended. 1. Introduction Pemphigus vulgaris (PV) and pemphigus foliaceus (PF) are organ-specific autoimmune bullous diseases characterized by loss of cell adhesion (acantholysis) and blister formation [1, 2]. These dermatoses are proven to be induced by autoimmune phenomenon [1–3]. Considering this etiology, immunosuppressive therapies are the main treatments available for these disorders. Infections are important complications in these patients attributable to disruption of the epidermal barrier due to the disease itself and immunosuppression induced by treatment [4, 5]. There are many reports regarding predisposition to infections due to immunosuppressive therapy and the immunocompromised state of pemphigus patients [6, 7]. PV has a high prevalence (30 per 100,000 inhabitants) in Iran; in this regard, we have studied this autoimmune disease from many different points of view [8–10]. The aim of the present study was to determine the rate of infection and pathogenic agents in PV patients admitted to dermatology inpatients service through a retrospective study. 2. Material and Methods This retrospective study was performed on 155 PV patients (87 females, 68 males) admitted to the dermatology service of

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