Department of Experimental, Diagnostic and Specialty Medicine - Dermatology - IRCCS Policlinico di Sant'Orsola, Bologna, Italy.
Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
J Dtsch Dermatol Ges. 2021 Nov;19(11):1613-1619. doi: 10.1111/ddg.14595. Epub 2021 Nov 3.
Pemphigus has been associated with physical and psychiatric comorbid diseases. This study aims to further investigate these associations in patients with pemphigus, and to analyze the relationships of comorbid conditions with sex and age, pemphigus disease area index score, diagnostic delay and cutaneous/mucous involvement.
Patients with pemphigus were matched by age, gender and area of residence with eight controls each. The odds of comorbid conditions in patients vs. matched controls was determined using univariate conditional logistic regression models. Comorbid diseases significantly associated with the diagnosis of pemphigus at P < 0.05 in univariate models were subsequently included in a multivariable conditional logistic regression model with a forward procedure.
The study sample included 163 patients with pemphigus. Cardiovascular diseases, hyperlipidemia, autoimmune thyroid disorders, dermatological autoimmune/inflammatory conditions and cancer were the most prominent conditions at the time of diagnosis. In the multiple conditional regression analysis, the two diagnoses independently associated with patients with pemphigus were cancer and dermatological autoimmune/inflammatory conditions. In sensitivity analyses excluding four patients with paraneoplastic pemphigus, these associations were still significant.
Cancer and dermatological autoimmune/inflammatory conditions may represent possible triggering conditions for pemphigus and should be considered as early warning signs for the disease.
天疱疮与躯体和精神共病疾病相关。本研究旨在进一步研究天疱疮患者的这些关联，并分析共病与性别和年龄、天疱疮疾病面积指数评分、诊断延迟和皮肤/黏膜受累的关系。
按年龄、性别和居住地与每位患者匹配 8 名对照。使用单因素条件逻辑回归模型确定患者与匹配对照者共病的几率。在单因素模型中天疱疮诊断显著相关的共病在 P<0.05 时，随后采用逐步向前的多因素条件逻辑回归模型纳入其中。
研究样本包括 163 例天疱疮患者。心血管疾病、血脂异常、自身免疫性甲状腺疾病、皮肤自身免疫/炎症性疾病和癌症是诊断时最突出的疾病。在多因素条件回归分析中，与天疱疮患者独立相关的两个诊断是癌症和皮肤自身免疫/炎症性疾病。在排除 4 例副肿瘤性天疱疮患者的敏感性分析中，这些关联仍然显著。
癌症和皮肤自身免疫/炎症性疾病可能是天疱疮的潜在触发因素，应将其视为疾病的预警信号。
