Impact of smoking on pemphigus.
BACKGROUND
A positive history of smoking is less common in patients with pemphigus than in healthy subjects. The aim of this case-control study was to compare the remission rate and clinical locations involved in smokers and nonsmokers with pemphigus vulgaris.


METHODS
Seventy patients with pemphigus vulgaris, treated with a uniform protocol, were enrolled. The sites of involvement, average time needed for disease control, and number of relapses were compared in smokers and nonsmokers. At the end of the first and second years of treatment, the rate of remission was compared in the two groups.


RESULTS
Ten of the patients were current cigarette smokers, but the other 60 (85.7%) had no history of smoking. There was no difference in the rate of cutaneous or mucosal involvement between smokers and nonsmokers. The predominant subtype was the mucocutaneous type in both groups. Smokers with pemphigus vulgaris achieved partial remission more frequently than nonsmokers at the end of the first year of treatment. The number of patients in remission at the end of the second year of therapy was significantly higher for smokers with pemphigus than for nonsmokers. The main reason for disease activity in both groups was recurrence.


CONCLUSIONS
Cigarette smoking may not affect the rate of cutaneous or mucosal involvement in pemphigus; however, the data indicate that remission may be achieved sooner in pemphigus patients who smoke.
Valikhani
Mahin
M
Pemphigus Research Center, Razi Hospital, Department of Dermatology, School of Medicine and Medical Sciences, University of Tehran, Tehran, Iran.
Kavusi
Suzan
S
Chams-Davatchi
Cheyda
C
Hallaji
Zahra
Z
Esmaili
Nafiseh
N
Ghandi
Narges
N
Farahani
Farzaneh
F
Lajevardi
Vahide
V
D000328:Adult; D001379:Azathioprine / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010392:Pemphigus / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D012074:Remission Induction; D012189:Retrospective Studies; D012867:Skin / Q000473:pathology; D012907:Smoking
D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine