Risk factors in patients with oral pemphigus vulgaris: a case-control study

Pemphigus vulgaris (PV) is considered a chronic disease with a potentially fatal outcome. Studies have suggested that environmental factors and personal habits play an important role in the pathogenesis of PV, but more studies are required to elaborate their connection to the disease. The goal of this multicenter case-control study was to determine some of the environmental factors related to PV. Cases (n = 99) were patients with PV, and controls (n = 198) were individuals who did not have PV. Data about demographics, history, clinical findings, occupational exposures to pesticides, smoking status, number of births (parity), herpes simplex virus (HSV) infection, and fast food consumption were collected using a structured questionnaire. Chi-square and logistic regression analyses were used for data analysis. Univariate logistic regression analysis indicated that the statistically significant factors related to PV were infection with HSV in recent weeks (odds ratio [OR], 3.35; 95% confidence interval [CI], 1.75-6.43), parity (OR, 0.50; 95% CI, 0.39-0.63), and lack of occupational exposure to pesticides (OR, 0.36; 95% CI, 0.21-0.60). Multivariate analysis revealed that significant factors were cessation of smoking (adjusted odds ratio [AOR], 4.36; 95% CI, 1.50-12.66), HSV infection (AOR, 2.91; 95% CI, 1.47-5.75), and lack of occupational exposure to pesticides (AOR, 0.35; 95% CI, 0.20-0.63). The findings indicated that cessation of smoking and HSV infection in recent weeks are risk factors for PV, while lack of occupational exposure to pesticides and increasing parity (a greater number of births) are protective factors against PV.