Evaluation of Ear, Nose, and Throat Involvement in Pemphigus Vulgaris in Comparison with Pemphigus Severity Scoring Systems: A Cross-sectional Study

Area of Science:

• Dermatology
• Otolaryngology

Background:

• Pemphigus vulgaris (PV) commonly affects the mucous membranes of the ear, nose, and throat (ENT).
• Current PV severity scoring systems (PDAI, ABSIS) lack comprehensive ENT evaluation.
• Undiagnosed ENT involvement in PV can lead to inaccurate disease assessment.

Purpose of the Study:

• To determine the actual extent of PV involvement in ENT areas.
• To identify specific disease scores that warrant an ENT examination.
• To assess the utility of endoscopic ENT examination for PV grading.

Main Methods:

• Patients with PV underwent endoscopic examination of ENT areas, irrespective of symptoms.
• Pemphigus Disease Area Index (PDAI), Autoimmune Bullous Skin Disorder Intensity Score (ABSIS), and a dedicated ENT score were calculated.
• Correlation and significance between PDAI, ABSIS, and ENT scores were analyzed.

Main Results:

• Mucosal involvement in ENT areas was more severe when assessed by endoscopic examination compared to PDAI or ABSIS.
• The ENT score showed significant association with symptoms and endoscopic findings.
• A significant correlation was observed when PDAI ≥15 and/or ABSIS ≥17.

Conclusions:

• Endoscopic ENT examination provides a more accurate assessment of PV mucosal involvement.
• An ENT endoscopic examination is recommended for PV patients with PDAI ≥15 and/or ABSIS ≥17, even without apparent ENT symptoms.
• Integrating ENT assessment improves comprehensive PV management.