Remission Rate of Pemphigus Vulgaris and Pemphigus Foliaceus in the Institute of Dermatology: A 7 Years Retrospective Study

Abstract

Pemphigus, an autoimmune blistering disease caused by autoantibodies targeting desmoglein 1, desmoglein 3, and desmosomal cadherins, is characterized by blister formation and can be a long-term condition with the possibility of relapse. This study aimed to evaluate the remission rates and compare them between pemphigus vulgaris (PV) and pemphigus foliaceus (PF) at the Institute of Dermatology. A retrospective analysis was conducted on 426 patients diagnosed and treated at the Institute of Dermatology in Bangkok, Thailand, between January 1, 2016, and December 31, 2022, for PV and PF. Patients were followed up for 1, 2, and 5 years to assess complete remission using Consensus statement criteria. The remission rates for PV and PF were 3.3%, 17.5%, and 48.4% at 1, 2, and 5 years, and 7.9%, 33.1%, and 61.6% at the same intervals, respectively. PF demonstrated significantly higher remission rates compared to PV at all time points (p< .001). The average time to remission was 60 months for PV and 36 months for PF. Prognostic factors associated with complete remission included age, age at onset, control of underlying disease, disease severity, primary site of involvement, and initial mucosal involvement. In conclusion, the remission rates for PV and PF at five years were 48.4% and 61.6%, respectively. PF achieved complete remission more frequently than PV. Good control of underlying disease, absence of initial mucosal involvement, and mild disease severity were associated with better prognosis for both PV and PF.