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Navigating the Complexities of Pemphigus Vulgaris: A Comprehensive Iranian Study
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  • Delaram Moosavi,
  • Seyed Mohammad mahdi Khadem,
  • Afsaneh Sadeghzadeh-bazargan,
  • Kambiz Kamyab Hesari,
  • Mehrnaz Azh,
  • Hamed Zarei Sharif,
  • Nasrin Shayanfar,
  • Azadeh Goodarzi
Delaram Moosavi
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
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Seyed Mohammad mahdi Khadem
Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran
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Afsaneh Sadeghzadeh-bazargan
Department of Dermatology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran

Corresponding Author:[email protected]

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Kambiz Kamyab Hesari
Department of Dermatopathology, Raazi hospital ,Tehran University of Medical Sciences, Tehran, Iran
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Mehrnaz Azh
Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Hamed Zarei Sharif
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Nasrin Shayanfar
Department of Pathology, Hazret-e-Rasoul Hospital, Iran University of Medical Sciences, Tehran, Iran
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Azadeh Goodarzi
Iran University of Medical Sciences
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Abstract

Introduction: Pemphigus vulgaris is a rare, autoimmune disorder characterized by blistering skin and mucous membrane lesions, often presenting with oral lesions in 50-70% of cases. It has a global incidence of 0.5-3.2 per 100,000 people, with variations across regions, and in Iran, the rate is about 1 per 100,000 annually. The disease typically manifests in the 6th decade of life, though the age of onset varies internationally, being younger in India and Western countries. Method: In this cross-sectional study, information of 63 patients, diagnosed with pemphigus vulgaris was confirmed by biopsy of the lesions, was collected during a telephone call. This project was approved by the Research Ethics Committee of Iran University of Medical Sciences. SPSS version 22 software was used for the statistical analysis of the data. Results: In a study of 63 pemphigus vulgaris patients, 56% were female and 44% male, with an average age of 50.17 years. Most patients initially presented with mucosal symptoms (70%), and the average time to diagnosis was about 17 months. Common misdiagnoses included aphthous ulcers, lichen planus, and allergic reactions. Post-diagnosis, most patients (82%) received multiple medications. Specific treatments included prednisolone (12%), methylprednisolone (1.7%), and methotrexate (1.7%). Also Those who initially managed their illness well tended to have more frequent and intense flare-ups later. Patients diagnosed early generally had fewer relapses, while those who first showed mucosal symptoms experienced longer periods without relapses. Also, being diagnosed late can affect how well treatments work and how the disease is managed. Discussion: Pemphigus vulgaris predominantly affects middle-aged women, typically emerging in their fifth decade, with mucosal symptoms often preceding skin manifestations. Delayed diagnosis, particularly in cases presenting with skin symptoms, may impact prognosis. Treatment choice and adjuvant therapy post-diagnosis may influence relapse rates, warranting further investigation.