Sharquie Khalifa E, Noaimi Adil A, Al-Jobori Ali A
Chairman of Scientific Council of Dermatology & Venereology, Iraqi Board for Medical Specializations, Baghdad, Iraq.
Int J Dermatol. 2014 Mar;53(3):288-93. doi: 10.1111/j.1365-4632.2012.05708.x. Epub 2013 Aug 22.
Pemphigus vulgaris is an autoimmune disease of the skin and mucous membrane. Renal transplantation is a common procedure in Iraq, and these patients required prolonged use of immunosuppressive drugs.
To study the frequency of skin tumors and infections in patients with pemphigus vulgaris compared with renal transplant recipients and normal controls.
One hundred kidney transplant recipients, their ages ranged from 14 to 70 (46.65 ± 4.74) years, and 50 patients with pemphigus vulgaris, their ages ranged from 22 to 70 (43.32 ± 3.46) years, were studied in Baghdad Hospital from June 2009 to August 2010. Patients were treated with immunosuppressive drugs for 0.5-25 years. Patients were examined for tumors and infections and compared with the general population as controls (100 individuals).
In renal transplant recipients, the following infections were observed: herpetic, 25 patients (25%); bacterial, 11 (11%); and fungal, 22 (22%). These infections appeared early in the course of immunosuppression. Benign tumors increased, most importantly viral warts in 40 (40%) and actinic keratosis, 14 (14%). The malignant tumors were basal cell carcinomas in 4 (4%), squamous cell carcinomas 2 (2%), and Kaposi's sarcoma 3 (3%). These malignancies usually appeared late in the course of immunosuppression. Patients with pemphigus vulgaris showed no important skin infections or tumors. Healthy controls showed no infections apart from herpetic infections in 7 (7%) and viral warts in 9 (9%). No tumors were seen.
Pemphigus vulgaris in prolonged immunosuppression is immunoprotective against skin infections and skin tumors while kidney transplant recipients are not protective.
寻常型天疱疮是一种皮肤和黏膜的自身免疫性疾病。肾移植在伊拉克是一种常见的手术，这些患者需要长期使用免疫抑制药物。
研究寻常型天疱疮患者与肾移植受者及正常对照相比皮肤肿瘤和感染的发生率。
2009年6月至2010年8月在巴格达医院对100例肾移植受者进行研究，年龄范围为14至70岁（46.65±4.74岁），以及50例寻常型天疱疮患者，年龄范围为22至70岁（43.32±3.46岁）。患者接受免疫抑制药物治疗0.5至25年。对患者进行肿瘤和感染检查，并与作为对照的普通人群（100人）进行比较。
在肾移植受者中，观察到以下感染：疱疹感染，25例（25%）；细菌感染，11例（11%）；真菌感染，22例（22%）。这些感染在免疫抑制过程早期出现。良性肿瘤增加，最重要的是病毒疣40例（40%）和光化性角化病14例（14%）。恶性肿瘤为基底细胞癌4例（4%）、鳞状细胞癌2例（2%）和卡波西肉瘤3例（3%）。这些恶性肿瘤通常在免疫抑制过程后期出现。寻常型天疱疮患者未出现重要的皮肤感染或肿瘤。健康对照除7例（7%）疱疹感染和9例（9%）病毒疣外未出现感染。未观察到肿瘤。
长期免疫抑制下的寻常型天疱疮对皮肤感染和皮肤肿瘤具有免疫保护作用，而肾移植受者则没有这种保护作用。
