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Coexistent Solid Malignancies in Pemphigus: A Population-Based Study.

Khalaf Kridin¹, Shira Zelber-Sagi², Doron Comaneshter³

¹Department of Dermatology, Rambam Health Care Campus, Haifa, Israel.

JAMA Dermatology

|February 18, 2018

Summary

Pemphigus, an autoimmune blistering disease, is associated with increased risks of esophageal and laryngeal cancers. This study highlights potential cancer risks in pemphigus patients, urging clinical awareness and further research.

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Area of Science:

Dermatology
Oncology
Epidemiology

Background:

The link between pemphigus vulgaris/foliaceus and comorbid malignancies requires further investigation.
Previous studies have not firmly established an association between pemphigus and various cancers.

Purpose of the Study:

To determine the association between pemphigus and a broad spectrum of nonhematologic malignancies.
To utilize a large cohort of pemphigus patients for robust statistical analysis.

Main Methods:

A cross-sectional study using a large Israeli healthcare database (Clalit Health Services) from 2004-2014.
Compared 1985 pemphigus patients with 9874 matched controls for the prevalence of 17 solid malignancies.
Employed univariate (chi-square, t-tests) and multivariate (logistic regression) analyses, including sensitivity analyses and adjustments for confounders.

Main Results:

A higher prevalence of esophageal cancer (OR 2.9) and laryngeal cancer (OR 2.0) was observed in pemphigus patients compared to controls.
No significant associations were found between pemphigus and other solid malignancies.
Results remained consistent after adjusting for comorbidities, medication use, and other risk factors.

Conclusions:

Pemphigus demonstrates a significant association with solid malignancies of the esophagus and larynx.
Clinicians should consider these findings when managing patients with pemphigus.
Further observational studies are recommended to validate these associations in diverse populations.