Evaluation of olfaction in patients with pemphigus vulgaris

Pemphigus vulgaris (PV) is an autoimmune disease characterized by acantholysis. PV decreases quality of life and leads to morbidity and mortality. Although the association between PV and otolaryngeal disease has been studied, its effect on olfaction has not been investigated objectively and quantitatively.

Twenty-eight patients with PV and 28 healthy volunteers were included in the study. Lesions were identified via nasal endoscopic examination. Nasal symptoms (itching, obstruction, pain, bleeding, and crusting) were recorded. Volunteers were asked to evaluate their olfactory function via a visual analog scale. The Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test was performed (butanol threshold test and identification test), and the score was calculated as the mean ± SD.

The mean age of the PV group (group 1: 10 male 18 female subjects) was 48.7 ± 8.9 years. The mean age of the control group (group 2: 17 male and 11 female subjects) was 48.0 ± 1.1 years. All nasal symptoms, except itching, were more severe in the PV group (p < 0.05). Nasal lesions were more common in the PV group (p = 0.0001). Evaluation of olfactory function revealed significantly lower scores in the PV group for both the butanol threshold test and the identification testing as well as the CCCRC total score (p = 0.001). PV patients with nasal lesions had significantly more nasal symptoms (p < 0.05). A negative correlation was found between the number of lesions and the olfactory scores in group 1 for the butanol threshold test, identification testing, and the CCCRC total scores, respectively (p = 0.002, p = 0.010, and p = 0.001, respectively).

PV causes olfactory dysfunction leading to eventual hyposmia that decreases quality of life. We suggest that olfactory testing be included in PV evaluation for the diagnosis and treatment of hyposmia, when necessary.