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Increased risk of severe course of pemphigus in patients with pemphigus‐associated alopecia: a prospective observational study
Author(s) -
SarPomian M.,
Czuwara J.,
Rudnicka L.,
Olszewska M.
Publication year - 2019
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/ced.13761
Subject(s) - pemphigus , pemphigus foliaceus , medicine , pemphigus vulgaris , dermatology , desmoglein 1 , desmoglein , paraneoplastic pemphigus , observational study , autoimmune disease , autoantibody , immunology , disease , antibody
Summary Background Pemphigus‐associated alopecia is considered rare, and has not been studied in detail. Aim To evaluate the clinical and immunological characteristics of patients with pemphigus‐associated alopecia. Methods This prospective observational study included 80 consecutive patients with histopathologically and immunopathologically confirmed pemphigus, of whom 11 (13.8%) were found to have pemphigus‐associated alopecia. Alopecia was observed in 11/52 patients with pemphigus and scalp involvement: [0/28 (35.7%) with pemphigus vulgaris and 1/24 (4.2%) with pemphigus foliaceus. The clinical and immunological characteristics of these patients were analysed. Results Patients with pemphigus‐associated alopecia had a significantly higher Pemphigus Disease Area Index total activity score compared with patients who had no pemphigus‐associated alopecia (21.8 ± 18.6 and 11.0 ± 20.5, respectively; P = 0.02). Mean serum anti‐desmoglein (Dsg)1 antibody concentration was 141.8 ± 66.9 U/mL and 60.0 ± 52.6 U/mL, respectively ( P = 0.03), and mean serum anti‐Dsg3 concentration was 126.6 ± 36.7 U/mL and 67.4 ± 52.5 U/mL, respectively ( P = 0.03). The values for achieving serological remission were 10% and 70%, respectively ( P = 0.02). Conclusions Pemphigus‐associated alopecia is a marker of severe disease and a treatment‐resistant disease course.