Clinical Analysis Of 75 Cases With Pemphigus

Pemphigus is a chronic, recurrent, severe intraepithelial disease characterized by flaccid blisters and erosions of the skin and mucous membranes and histologically by acantholysis.It is mediated by circulating desmoglein-reactive autoantibodies directed against keratinocyte cell surfaces. The clinical manifestations and treatments are affected significantly by the type of pemphigus, mucosal injury and severity of patients. The acurate assessment of the content above can guide clinicians on the judgment of disease and the options of treatment.Objective Through retrospective analysis of the general situation, clinical manifestation when starting and being hospitalized, laboratory examination and treatment of patients with moderate and severe pemphigus in hospital, we mainly discusses the interactions of clinical manifestation, severity, treatment and prognostic between pemphigus vulgaris and pemphigus erythematosus. The purpose of this artical is to strengthen the understanding of pemphigus and make every effort to get a good treatment plan.Methods We retrospectively analyzed 75 cases of hospitalized patients with pemphigus in our department from February 2005 to July 2015. We group the patients respectively according to the type of pemphigus, severity, mucosal involvement or not and the treatments. The analysis and conclusion are made by statistical methods.Results Clinical features: The majority type of Pemphigus is PV, accounting for 73.33%. The mucosal involvement rate and heavy share of patients of group PV are obviously higher than that of group PE(P<0.05).The rate with mucous membrane and scalp involvement in severe group are obviously higher than that of moderate group(P<0.05). Women with vulva involvement are more than men(P<0.05).Treatments:(1)The compare in all patients: The total steroid dose before reduction and duration of steroid reduction of group PV are higher than that of group PE(P<0.05). The beginning steroid dose, disease-controlled maximal steroid dose, total steroid dose before reduction and total steroid dose during hospitalization of severe group are obviously higher than that of moderate group(P<0.05).(2)In group PV only, the beginning steroid dose,disease-controlled maximal steroid dose, total steroid dose before reduction and total steroid dose during hospitalization of severe group are obviously higher than that of moderate group(P<0.05).(3)The compare in severe group: the duration of beginning steroid dose, the duration of disease-controlled maximal steroid dose, total steroid dose before reduction and duration of steroid reduction of female are higher than that of male(P<0.05).(4)In patients with mucosal damage, the disease-controlled maximal dose, total steroid dose before reduction and total steroid dose during hospitalization of severe group are obviously higher than that of moderate group(P<0.05). In patients with mucosal damage, the total steroid dose before reduction and duration of steroid reduction of female are higher than that of male(P<0.05).Prognosis: The cure-rate and cure-remarkable-effectiveness rate of group PE is higher than group PV, as well as in moderate group and severe group.(P<0.05).The cure-rate of no mucosal damage group are higher than that of mucosal injury group(P<0.05).Conclusion In pemphigus, PV is the most common, serious, often mucous membrane involvement type. In contrast to male, female are more to be involved in mucous membrane bother,especially vulva. It is more difficult to reach remission in female whose conditions are serious. Mucous membrane and scalp involvement relate positively to the severity. The total disease-controlled steroid dose before reduction and duration of steroid reduction of group PV are higher. Mucous membrane involvement and disease severity are the important factors those influence the dose and duration of steroid, which is associated positively. We find prognosis is associated negatively with the type of pemphigus, mucous membrane involvement and disease severity.