Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA.
Department of Dermatology, University of Lübeck, Lübeck, Germany.
J Eur Acad Dermatol Venereol. 2018 Aug;32(8):1256-1262. doi: 10.1111/jdv.14886. Epub 2018 Mar 13.
Epidemiological evidence suggests that smoking cigarettes may be beneficial in pemphigus, but no systematic evaluation exists to corroborate this assumption. Therefore, a systematic literature review with pooled data analysis of the smoking status in patients with pemphigus was conducted. Electronic searches using PubMed from inception to November 2017 identified 13 reports meeting predetermined inclusion and exclusion criteria. Most were case-control studies partly reporting that pemphigus vulgaris and foliaceus occurred less frequently in current and former smokers. Studies also indicated that duration of smoking and number of cigarettes smoked were lower in patients with pemphigus than controls and that remission may be achieved sooner in those who smoke. However, although a generally low prevalence of smoking was demonstrated in patients with pemphigus, which was lower than in controls by pooled analysis, some investigations found no difference regarding the smoking status compared with non-pemphigus subjects. One study demonstrated more severe mucosal involvement in non-smoking patients with pemphigus, whereas another observed no difference in the rate of cutaneous or mucosal lesions between smokers and non-smokers with pemphigus. This review indicates that smoking may be a possible protective factor in pemphigus, although some compromised study methodologies yet hinder any firm conclusion. Further investigations with a refined quality design are required to resolve the so far partly conflicting results in this area.
流行病学证据表明，吸烟可能对天疱疮有益，但尚无系统评估来证实这一假设。因此，我们进行了一项系统的文献综述，并对天疱疮患者的吸烟状况进行了汇总数据分析。从 1997 年 1 月至 2017 年 11 月，我们使用 PubMed 进行了电子检索，确定了 13 项符合预定纳入和排除标准的报告。这些报告大多为病例对照研究，部分报告显示寻常型和落叶型天疱疮在现吸烟者和曾吸烟者中的发生率较低。研究还表明，与对照组相比，天疱疮患者的吸烟持续时间和吸烟量较低，且吸烟患者可能更快缓解。然而，尽管汇总分析显示天疱疮患者的吸烟率普遍较低，但与非天疱疮患者相比，一些研究发现吸烟状况没有差异。一项研究表明，非吸烟天疱疮患者的黏膜受累更严重，而另一项研究则观察到天疱疮患者的皮肤或黏膜病变发生率在吸烟者和非吸烟者之间没有差异。这篇综述表明，吸烟可能是天疱疮的一个可能的保护因素，尽管一些有缺陷的研究方法仍妨碍得出任何明确的结论。需要进一步进行具有改良质量设计的研究，以解决该领域目前部分相互矛盾的结果。
