Pemphigus Vulgaris and Infections: A Retrospective Study on 155 Patients

Abstract

Background. Autoimmune process and immunosuppressive therapy of pemphigus vulgaris would predispose the patients to infections. Aim. We aimed to study the prevalence of infection and pathogenic agents in pemphigus vulgaris patients admitted to dermatology service. Material and methods. This retrospective study was conducted on 155 pemphigus vulgaris patients (68 males, 87 females) admitted to dermatology service between 2009 and 2011. In this study, the diagnosis of pemphigus vulgaris was confirmed by light microscopic and direct immunofluorescence findings. Data were collected through a questionnaire. Results. Of 155 pemphigus vulgaris patients, 33 had infection at admission and 9 acquired nosocomial infection. In addition, 37 cases of oral candidiasis and 15 cases of localized herpes simplex were recorded. Totally, 94 cases of infection were recorded. The occurrence of infection was significantly related to the severity of disease, number of hospital admissions, and presence of diabetes mellitus. The most common pathogenic germs isolated from cultures were Staphylococcus aureus and Escherichia coli. Conclusion. Severity of pemphigus vulgaris and diabetes were directly related with tendency to infections. Staphylococcus aureus and Escherichia coli were the most common pathogenic agents. Due to limitations of retrospective study, a prospective study is recommended.

Pemphigus Foliaceus with Herpes Simplex Virus;A Case Report

“…They could not detect these viruses in any of these patients [11]. Another retrospective study by Esmaili et al in 2013 on 155 patients of pemphigus 9.68% were found to have localized herpes simplex infection [12]. In a recent study in 2013 by Mahnaz Banihashmi et al 30 diagnosed cases of pemphigus were analysed for presence of HSV1, EBV, HSV2 and HHV8 by immunohistochemistry.…”

Pemphigus Diagnostikos Ir Gydymo Aktualijos

“…Šios ligos prognozė iki gydymo eros sisteminiais kortikosteroidais (KS) ir imunosupresiniais vaistais daž-niausiai buvo bloga. Gausios akantolizinės pūslės ir išpli-tusios šlapiuojančios erozijos odoje ir gleivinėse, skysčių ir proteinų netekimas, elektrolitų disbalansas dėl odos barjero pažeidimo, antrinė bakterinė, virusinė ar grybelinė infekcijos buvo letalios baigties priežastys [1,2]. Pemphigus diagnostika sudėtinga, dažnai -pavėluota, ypač kai bėrimai prasideda tik burnos gleivinėje.…”

“…Literatūros duomenimis, sergant pemphigus, šių infekcijų dažnis siekia 60 -68 proc. Neretai šios infekcijos sukelia sunkias komplikacijas ir gali lemti fatalinę baigtį [2]. Antrinių infekcijų profilaktikai skiriamos vonios su antiseptikais, vietiniai antiseptikai ir antibiotikai, antivirusinis gydymas herpetinės infekcijos profilaktikai.…”

A Nosocomial Infection Manifested as Erysipelas in Pemphigus Foliaceous Patient under Intravenous Dexamethasone Treatment

“…5 Hospitalization in addition to corticosteroid therapy (with or without adjuvant immunosuppressive agents) would predispose the pemphigus patients to infection, with skin infection as one of the most frequently acquired. 4 This is a case report of nosocomial infection manifested as erysipelas in a patient under immunosuppressive therapy.…”

“…2 The etiology of SSTIs may be normal host flora transferred through a break in the barrier, such as instrumentation (eg, needles), that could permit the entry of normal skin flora and indigenous flora from the instrument of penetration. 3 Esmaili et al 4 reported that S. aureus responsible for 93,7% of skin infections in pemphigus patients.…”