Pemphigus in Guilan: Clinical and epidemiologic features of 126 hospitalized patients

Background: Pemphigus is a serious blistering disease with considerable mortality, which heavily burdens on health care system because of the long time hospitalization. It is rare in north America but is considered as the most common immunobullous disease in eastern countries such as Malaysia and China. Objective: The purpose of this study was to define the epidemiologic features of pemphigus in north of Iran. Patients and Methods: One-hundred and twenty-six cases of pemphigus diagnosed based on clinicohistological findings that were hospitalized in Rasht, in north of Iran, between 1995-2001 were studied. Epidemiological data collected from their hospital records were entered in SPSS software and statistical analyses were performed by T-test, Chi-square and Pearson correlation tests. Results: Pemphigus vulgaris was the most common type (83%), followed by foliaceous (6%) and vegetans (1%). The mean age of patients was 45.6 years, with 47.2 in vulgaris and 37.8 in foliaceous group (P<0.05). There was no sex difference in mean age in vulgaris group, whereas the mean age of foliaceous group was 30.2 for females and 51.8 years for males (P<0.05). Female:male ratio was 1.5:1, with 1.44:1 for vulgaris and 1.85:1 for foliaceous groups, respectively. The oral mucosa was the first site of involvement in 63% of vulgaris cases, and 72.4% of them had widespread mucocutaneous disease at the time of hospitalization. Frequency of illness in spring (32%) was higher than other seasons. The mean time for 80% improvement of lesions in hospital was significantly higher in cases with widespread mucocutaneous lesions than cases with only skin or mucosal illness (P<0.05). Conclusion: These findings clearly demonstrate the need for continuous training of involved health workers (Dermatologists, dentists, otolaryngologists, general physicians) for early diagnosis and referral of disease, which not only could decrease the morbidity and mortality, complications rates for patients but also hospitalization costs for patients and health care system.