Pemphigus: clinical features, epidemiology, and therapeutic management in a high-complexity hospital in Medellín, Colombia, 2019–2023
Keywords:
autoantibodies; pemphigus; bullous diseases; immunosuppressants; stomatology; Colombia.Abstract
Introduction: Pemphigus is a rare autoimmune blistering disease with a broad clinical spectrum requiring multidisciplinary management. In Colombia, data on its presentation and treatment are scarce, and the role of oral health professionals in early diagnosis has been poorly documented.
Objective: To describe the epidemiological and clinical characteristics and therapeutic management strategies in patients diagnosed with pemphigus, attended in the Stomatology, Maxillofacial Surgery, and Dermatology services of a high-complexity hospital in Medellín, Colombia.
Methodology: Observational, descriptive, and retrospective study including 51 patients with confirmed diagnoses of pemphigus vulgaris, foliaceus, herpetiformis, or other subtypes, seen between January 2019 and December 2023. Demographic variables, clinical subtype, severity, and treatment modalities were analyzed. Statistical analysis included frequencies, central tendency measures, and standard deviation, using IBM SPSS Statistics v.22.0.
Results: 70.6 % of patients were female, with a mean age of 41.12 ± 5 years. Pemphigus vulgaris was the most frequent subtype (78.43 %), predominantly presenting with oral mucosal involvement. Systemic therapy was required in 78.43 % of cases; azathioprine was the most commonly used immunomodulatory agent (66 %). No patient received rituximab due to access barriers.
Conclusion: Pemphigus vulgaris with predominant oral involvement was the most frequent subtype at this Colombian center. The role of the oral health team in early diagnosis was evident. A multidisciplinary approach is essential for timely management. Access barriers to rituximab, with implications for health policy and drug coverage, should be addressed in future research.
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