title: [Predisposition to infection in patients with pemphigus. Retrospective study of 141 cases].
abstract: BACKGROUND
  The relation between pemphigus and infection is complex. The aim of this work was to determine the frequency and impact of infection as well as the factors associated with it among our patients with pemphigus.
  
  
  METHODS
  This retrospective case series examined records of patients with pemphigus admitted to the dermatology unit of Ibn Sina University Hospital of Rabat between 1989 and 2004. We compared the patients with and without infections as well as the patients with and without severe bacterial infections according to patient profile and outcome. The principal outcome measure was death and the secondary measure, duration of hospitalization.
  
  
  RESULTS
  Of the 141 patients with pemphigus included in our study, 68% developed an infection. Infections were bacterial in 52% of cases, fungal in 50%, herpetic in 19% and parasitic in 1.5%. They were associated with diabetes mellitus and immunosuppressive drugs. Severe bacterial infection was frequent in patients with diabetes and rare in those treated with corticosteroids or with pemphigus foliaceous. Death occurred significantly more often among infected subjects (p=0.01), especially those with severe bacterial infections (p<0.001). Hospitalization was slightly longer among patients with infections (p=0.01) but shorter in cases of severe bacterial infections (p=0.004).
  
  
  CONCLUSIONS
  Our study confirms the predisposition to all types of infection among patients with pemphigus, as well as the undeniable role its treatment plays in promoting infection. Severe bacterial infections were most often contracted before hospitalization. The literature reports a wide variety of infections, with pemphigus-herpes documented most often. Prevention and management require hygienic measures as well as early diagnosis and treatment of pemphigus and infections. Preventive treatment may be considered, but studies are needed to define the patients who might benefit from it.
authors.affiliation: Service de dermatologie, Hôpital Ibn Sina, Rabat, Morocco. fbelgnaoui@yahoo.fr
authors.forename: Fatima Zahra
authors.initials: FZ
authors.lastname: Belgnaoui
authors.forename: Karima
authors.initials: K
authors.lastname: Senouci
authors.forename: Hanane
authors.initials: H
authors.lastname: Chraibi
authors.forename: Abdelaziz
authors.initials: A
authors.lastname: Aoussar
authors.forename: Fatima
authors.initials: F
authors.lastname: Mansouri
authors.forename: Laila
authors.initials: L
authors.lastname: Benzekri
authors.forename: Mohamed Ait
authors.initials: MA
authors.lastname: Ourhroui
authors.forename: Redouane
authors.initials: R
authors.lastname: Abouqal
authors.forename: Ernest
authors.initials: E
authors.lastname: Heid
authors.forename: Badredine
authors.initials: B
authors.lastname: Hassam
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015984:Causality; D005260:Female; D006801:Humans; D007239:Infections / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000150:complications*; D012189:Retrospective Studies