Factors associated with the healing time of pemphigus vulgaris oral lesions: A prospective study.

Abstract

This study determines the healing time of lesions on different locations and the contributing factors to the healing time in patients with pemphigus. In this prospective study, newly diagnosed patients with mucosal lesions were included. A dermatologist evaluated the lesions, disease status, side effects and assigned the PDAI. Follow-up visits were conducted monthly until the patient reached complete remission and every three months thereafter. A Tzanck smear was performed on lesions clinically suspected to be herpetic in origin. Sixty patients enrolled in the study with a mean age of 45.9 ± 11.7years. The buccal lesions took the longest to resolve (73[33.5-105.5] days). However, the posterior pharynx lesions showed the shortest healing time (20[13.0-25.5] days). The likelihood of improvement in buccal and soft palate lesions decreased by 5% and 3% with each additional year of age, respectively. Also, the resolution duration of soft palate lesions was significantly shorter in female patients than males (median of 24.0days vs. 38.5days). In contrast, lower gingival lesions resolve significantly faster in male patients by a median of 9days. Herpes simplex virus infection increases the healing time of lesions by 26days (median of 55days vs. 29days, hazard ratio 2.62, 95% CI: 1.04-5.92). Buccal and lower gingival lesions are more recalcitrant to treatment, while posterior pharynx lesions heal most rapidly. Furthermore, older age was also associated with a lower rate of lesion improvement.