Investigating Atherosclerosis through Ultrasonographic Assessment of Carotid Intima-Media Thickness in Pemphigus...

Pemphigus vulgaris (PV) is an autoimmune blistering dermatosis affecting both sexes. Previous studies suggest an increased cardiovascular risk in PV patients, though the underlying mechanisms remain unclear.

This case-control study evaluated carotid intima-media thickness (CIMT) via ultrasonography as a marker of subclinical atherosclerosis in PV. Seventy patients were categorized based on disease duration (<1 year and 1-4 years) and compared to 35 age- and gender-matched healthy controls. Data on demographics, Pemphigus Disease Area Index (PDAI), and total rituximab (RTX) dosage were collected.

Age was significantly correlated with CIMT in all groups. Although left and right plaque presence was significant in controls (p = 0.007), no significant plaque burden was observed in either patient group. CIMT showed a significant positive correlation with waist circumference in the <1 year group and controls (p = 0.027 and p = 0.001, respectively), and with BMI in the <1 year group. PDAI was significantly associated only with left CIMT in patients with 1-4 years of disease (p = 0.035). Additionally, male patients in the 1-4 year group had significantly higher left and right CIMT (p = 0.014 and p = 0.047, respectively). No significant differences in CIMT size or plaque presence were observed between patient and control groups.

These findings suggest that age, gender, BMI, waist circumference, and disease severity may contribute to subclinical atherosclerosis in PV, with plaque formation potentially linked to persistent inflammation.