Bastuji-Garin S, Souissi R, Blum L, Turki H, Nouira R, Jomaa B, Zahaf A, Ben Osman A, Mokhtar I, Fazaa B
Department of Public Health, H. Mondor Hospital, Paris XII University, Créteil, France.
J Invest Dermatol. 1995 Feb;104(2):302-5. doi: 10.1111/1523-1747.ep12612836.
Recent studies have suggested that in Tunisia, pemphigus foliaceus is more frequent in young women than expected. To confirm these findings, we compared the incidence rates of pemphigus in Tunisia as a whole and in a large area of France. New cases of pemphigus were detected retrospectively from dermatology departments and pathology laboratories over a 6-year period and classified as pemphigus vulgaris or foliaceus according to the pathology. In France, the incidence rate was 1.7 cases per million per year (95% confidence interval 1.4 to 2.1). Pemphigus vulgaris accounted for 73% of all cases, incidence increased with age, and the female-to-male sex ratio was 1.2. The incidence rate was significantly higher in Tunisia than in France: 6.7 cases per million per year (95% confidence interval 5.8 to 7.7); pemphigus foliaceus was more frequent (61%), the female-to-male sex ratio was 4.1, and the incidence rate was higher in young women. The incidence rate was 15.5 cases per million per year for pemphigus foliaceus among women aged 25 to 34 years and was even higher in some rural areas. No case was observed among household members or in neonates, and only one case occurred in childhood. Thus, we confirmed that the epidemiology of pemphigus in Tunisia is unusual. High rates of pemphigus foliaceus among young people living in rural areas are reminiscent of Brazilian pemphigus. However, the absence of cases among genetically related household members and during childhood, and the large predominance of women, contrast with Brazilian pemphigus.
最近的研究表明，在突尼斯，落叶型天疱疮在年轻女性中的发病率高于预期。为了证实这些发现，我们比较了整个突尼斯和法国大片地区天疱疮的发病率。通过回顾性研究，在6年时间里从皮肤科和病理实验室检测出天疱疮新病例，并根据病理结果将其分为寻常型天疱疮或落叶型天疱疮。在法国，发病率为每年每百万人口1.7例（95%置信区间为1.4至2.1）。寻常型天疱疮占所有病例的73%，发病率随年龄增长而增加，女性与男性的性别比为1.2。突尼斯的发病率明显高于法国：每年每百万人口6.7例（95%置信区间为5.8至7.7）；落叶型天疱疮更为常见（61%），女性与男性的性别比为4.1，且年轻女性的发病率更高。25至34岁女性中落叶型天疱疮的发病率为每年每百万人口15.5例，在一些农村地区甚至更高。在家属或新生儿中未观察到病例，儿童期仅出现1例。因此，我们证实突尼斯天疱疮的流行病学情况不寻常。生活在农村地区的年轻人中落叶型天疱疮的高发病率让人联想到巴西天疱疮。然而，与巴西天疱疮不同的是，在有基因关联的家庭成员中以及儿童期未出现病例，且女性占主导地位。
