Volume 19, Issue 11 pp. 1613-1619
Original Article

Comorbid diseases associated with pemphigus: a case-control study

Federico Bardazzi

Federico Bardazzi

Department of Experimental, Diagnostic and Specialty Medicine – Dermatology – IRCCS Policlinico di Sant'Orsola, Bologna, Italy

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Paola Rucci

Paola Rucci

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy

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Simona Rosa

Simona Rosa

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy

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Camilla Loi

Camilla Loi

Department of Experimental, Diagnostic and Specialty Medicine – Dermatology – IRCCS Policlinico di Sant'Orsola, Bologna, Italy

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Marica Iommi

Marica Iommi

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy

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Ambra Di Altobrando

Corresponding Author

Ambra Di Altobrando

Department of Experimental, Diagnostic and Specialty Medicine – Dermatology – IRCCS Policlinico di Sant'Orsola, Bologna, Italy

Correspondence to

Ambra Di Altobrando, MD

Department of Experimental, Diagnostic and Specialty Medicine – Dermatology – IRCCS Policlinico di Sant'Orsola

Via Massarenti 1

40138 Bologna, Italy

E-mail: [email protected]

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First published: 03 November 2021
Citations: 3

Summary

Background and objectives

Pemphigus has been associated with physical and psychiatric comorbid diseases. This study aims to further investigate these associations in patients with pemphigus, and to analyze the relationships of comorbid conditions with sex and age, pemphigus disease area index score, diagnostic delay and cutaneous/mucous involvement.

Patients and methods

Patients with pemphigus were matched by age, gender and area of residence with eight controls each. The odds of comorbid conditions in patients vs. matched controls was determined using univariate conditional logistic regression models. Comorbid diseases significantly associated with the diagnosis of pemphigus at P < 0.05 in univariate models were subsequently included in a multivariable conditional logistic regression model with a forward procedure.

Results

The study sample included 163 patients with pemphigus. Cardiovascular diseases, hyperlipidemia, autoimmune thyroid disorders, dermatological autoimmune/inflammatory conditions and cancer were the most prominent conditions at the time of diagnosis. In the multiple conditional regression analysis, the two diagnoses independently associated with patients with pemphigus were cancer and dermatological autoimmune/inflammatory conditions. In sensitivity analyses excluding four patients with paraneoplastic pemphigus, these associations were still significant.

Conclusions

Cancer and dermatological autoimmune/inflammatory conditions may represent possible triggering conditions for pemphigus and should be considered as early warning signs for the disease.

Conflict of interest

None.

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