Valikhani M, Kavusi S, Chams-Davatchi C, Daneshpazhooh M, Barzegari M, Ghiasi M, Abedini R
Pemphigus Researh Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Clin Exp Dermatol. 2007 May;32(3):256-60. doi: 10.1111/j.1365-2230.2007.02390.x. Epub 2007 Mar 13.
Recent reports have revealed the relatively high incidence of pemphigus in Iran. Occupational exposure and personal habits have been suggested to play a role in the aetiopathogenesis of this life-threatening disease.
In order to analyse the association of environmental factors with pemphigus, we conducted a case-control study to evaluate the possible role of smoking, pesticide exposure and hormonal factors in Iran.
This study was conducted in Iran using a structured questionnaire. Questions included information on patients' smoking habits, occupational exposure to pesticides, use of oral contraception (OC) and number of pregnancies.
We enrolled 210 patients with pemphigus and 205 control subjects. Fewer of patients with pemphigus (17.1%) reported a current or past history of smoking, which was statistically different from the control group (27.3% smokers). The duration of smoking and the number of cigarettes smoked daily was also significantly lower in patients. Although OC use was significantly higher in women with pemphigus, the mean number of pregnancies was not different between the two groups. Occupational exposure to pesticides was significantly higher in patients with pemphigus (14.8%) than in controls (5.4%); patients with pemphigus were exposed to pesticides three times more often than were healthy subjects.
As a positive history of smoking was lower in patients with pemphigus compared with healthy subjects, it seems that smoking is a protective factor in pemphigus. This should encourage further investigations, searching for novel therapies. If pesticides and OC are confirmed as triggering factors, their cessation might reduce the need for pharmacological therapy.
最近的报告显示伊朗天疱疮发病率相对较高。职业暴露和个人习惯被认为在这种危及生命的疾病的病因发病机制中起作用。
为了分析环境因素与天疱疮的关联，我们进行了一项病例对照研究，以评估吸烟、接触农药和激素因素在伊朗可能发挥的作用。
本研究在伊朗使用结构化问卷进行。问题包括患者的吸烟习惯、职业性接触农药、使用口服避孕药（OC）以及怀孕次数等信息。
我们纳入了210例天疱疮患者和205例对照受试者。天疱疮患者中报告有当前或既往吸烟史的较少（17.1%），这与对照组（27.3%的吸烟者）在统计学上有差异。患者的吸烟持续时间和每日吸烟量也显著较低。虽然天疱疮女性患者使用OC的比例显著更高，但两组的平均怀孕次数没有差异。天疱疮患者职业性接触农药的比例（14.8%）显著高于对照组（5.4%）；天疱疮患者接触农药的频率是健康受试者的三倍。
由于天疱疮患者的吸烟阳性史低于健康受试者，似乎吸烟是天疱疮的一个保护因素。这应该鼓励进一步的研究，寻找新的治疗方法。如果农药和OC被确认为触发因素，停止接触它们可能会减少药物治疗的需求。
