Patient-Reported Outcomes on Quality of Life in Older Adults with Oral Pemphigus

Background: Oral pemphigus is a rare autoimmune blistering disorder predominantly affecting the mucous membranes, particularly in older adults. Despite therapeutic advances, the chronic, painful, and recurrent nature of oral pemphigus vulgaris substantially impairs patients' quality of life (QoL). Patient-reported outcomes (PROs) offer valuable insights into the subjective burden of the disease; however, data on PROs in older adults with oral pemphigus are scarce. Objective: To assess QoL in older adults diagnosed with oral pemphigus using validated PRO measures and to identify key clinical factors associated with QoL deterioration. Methods: A cross-sectional pilot study was conducted involving 10 participants aged 60 years or older with confirmed oral pemphigus vulgaris. Participants completed the Oral Pemphigus-Specific Quality of Life Questionnaire (OP-QoLQ) and the Dermatology Life Quality Index (DLQI). Clinical severity was evaluated using the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS). Statistical analyses explored correlations between disease severity, treatment regimens, and QoL outcomes. Results: Most participants reported moderate to severe QoL impairment, with eating difficulties and emotional distress being the most frequently mentioned issues. Higher ABSISs and longer disease duration were significantly correlated with poorer OP-QoLQ and DLQI outcomes (Spearman's ρ up to 0.80; p ≤ 0.021). Systemic corticosteroid therapy was more frequently reported among those with advanced disease, although treatment-related adverse effects may contribute to reduced QoL. Conclusion: Oral pemphigus substantially compromises QoL in older adults, with both disease- and treatment-related factors playing important roles. These findings support the integration of PROs into the multidisciplinary management of older adults with oral pemphigus vulgaris.