Epidemiology of pemphigus in Macedonia: a 15-year retrospective study (1990-2004).
BACKGROUND
Pemphigus is an autoimmune blistering skin disease mediated by auto-antibodies directed against desmoglein proteins. There are only a few epidemiological studies on pemphigus. Our objective was to determine the epidemiological features of pemphigus in Macedonia, and to compare the results with those reported elsewhere.


METHODS
Diagnosis in all cases was confirmed by histopathology and direct immunofluorescence. Binomial distribution testing and Fisher's exact-test at the 0.01 level of significance were used to determine if particular demographic groups were over-/ under-represented among the pemphigus patients.


RESULTS
One hundred and thirty-three new pemphigus cases were diagnosed in Macedonia from 1990-2004. The average annual incidence was 0.44/100,000 inhabitants (SD = 0.17). The incidence doubled to 0.89 in 2001 during the local armed unrest. The disease did not affect either gender to a greater extent. The average annual incidence was 0.51 for ethnic Macedonians. Roma (Gypsies) had a statistically significantly higher incidence of pemphigus at 2.4 cases/100,000 individuals. Ethnic Albanians had statistically significantly lower incidence of 0.1 cases/100,000 individuals. The most common variant was pemphigus vulgaris (77.4%).


CONCLUSIONS
The annual incidence for pemphigus in Macedonia is 0.44 cases/100,000 inhabitants. Most common form was pemphigus vulgaris. An epidemiological peak occurred in 2001 during the local armed conflict. Macedonian Roma had a sixfold higher incidence of pemphigus compared with the overall population; ethnic Albanians had a fourfold lower incidence.
V'lckova-Laskoska
Marija T
MT
Department of Dermatology, School of Medicine, University of Sts. Cyrilus and Methodius, Skopje, Macedonia. lasko@lasko.com.mk
Laskoski
Dimitri S
DS
Kamberova
Suzana
S
Caca-Biljanovska
Nina
N
Volckova
Nadja
N
D000328:Adult; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000175:diagnosis / Q000453:epidemiology*; D015995:Prevalence; D018843:Republic of North Macedonia / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors