title: Increased incidence of pemphigus vulgaris in southern Europeans living in Germany compared with native Germans.
abstract: BACKGROUND
  The two major subtypes of pemphigus include: pemphigus vulgaris (PV) and pemphigus foliaceus. Only limited data are available on the epidemiology of these diseases.
  
  
  OBJECTIVE
  The aim of the present study was to estimate the gender- and age-specific incidences of PV in two well-defined regions of Germany and to compare the incidences among native Germans with those in citizens from other countries living in Germany.
  
  
  METHODS
  We performed a retrospective review of records from all patients that were diagnosed with PV at the Departments of Dermatology in Würzburg and Mannheim between 1989 and 1997.
  
  
  RESULTS
  During the observation period, 14 patients were diagnosed with PV coming from an area with 1.46 million residents. With regard to the patients' age, the highest incidence for women was found in the 51-65-year-old-age group with 2.34 [95% confidence interval (CI): 0.36; 7.76] new cases per 1 million inhabitants per year. The highest incidence for men was observed in the over 65-year-old age group with 3.72 (95% CI: 0.95; 9.8) cases/million peryear. In the 51-65-year-old age group,we found a 25-foldhigher incidence of PV in foreigners living in Germany compared with native Germans. The age-adjusted incidence of PV was ninefold higher in foreigners compared with native Germans. Interestingly, all non-German patients came from two southern European countries (Turkey and Italy).
  
  
  CONCLUSIONS
  The age-adjusted incidence of PV differs between native Germans and foreigners living in Germany. Further studies are necessary to address the risk factors (genetic and/or environmental) that contribute to this difference.
authors.affiliation: Department of Dermatology, University of Würzburg, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Hahn-Ristic
authors.forename: B
authors.initials: B
authors.lastname: Rzany
authors.forename: M
authors.initials: M
authors.lastname: Amagai
authors.forename: E B
authors.initials: EB
authors.lastname: Bröcker
authors.forename: D
authors.initials: D
authors.lastname: Zillikens
mesh_terms: D000368:Aged; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007558:Italy / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000453:epidemiology* / Q000208:ethnology; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey / Q000208:ethnology