RefDoc
Haut

Faire une nouvelle recherche
Make a new search
Lancer la recherche


Titre du document / Document title

Pemphigus vulgaris: environmental factors. Occupational, behavioral, medical, and qualitative food frequency questionnaire

Auteur(s) / Author(s)

BRENNER Sarah ; TUR Ethel ; SHAPIRO Jonathan ; RUOCCO Vincenzo ; D'AVINO Mariarosaria ; RUOCCO Eleonora ; TSANKOV Nikolai ; VASSILEVA Snejina ; DRENOVSKA Kossara ; BREZOEV Petjo ; BARNADAS M. A. ; GONZALEZ M. J. ; ANHALT Grant ; NOUSARI Hossein ; RAMOS-E SILVA Marcia ; TEIXEIRA PINTO Katia ; MIRANDA Maria Flora ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

Department of Dermatology, Tel Aviv Elias Sourasky Medical Center and Sackler School of Medicine, Tel Aviv University, Tel Aviv, ISRAEL
Department of Dermatology, 2nd University of Naples, Naples, ITALIE
Department of Dermatology and Venereology, Faculty of Medicine, Sofia, BULGARIE
Department of Dermatology, Hospital de la Sta. Creu I St. Pau, Barcelona, ESPAGNE
Johns Hopkins University, School of Medicine, Baltimore, Maryland, ETATS-UNIS
Servico de Dermatologia, Hospital Universitario Clementino Fraga Filho, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, BRESIL
Department of Dermatology, Venereology, and Leprology, Goa Medical College, Goa, INDE

Résumé / Abstract

Background There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. Factors suggested include exposure to pesticides or certain drugs. Objective To analyze the association of pemphigus with environmental exposure to various agents, including smoking, recreational and occupational insults, drugs, and food. Design and setting In-person interviews of pemphigus patients and control subjects were conducted by trained medical investigators using a structured questionnaire. Questions included occupational, behavioral, medical, and qualitative food frequency details. The multicenter study was conducted at outpatient services of teaching hospitals in Bulgaria, Brazil, India, Israel, Italy, Spain, and the USA. Participants A total of 126 pemphigus patients (55 men, 71 women; age, 54 ± 17 years) and 173 healthy controls (87 men, 86 women; age 50 ± 19 years) were interviewed in the period between October 1, 1999 and March 31, 2000. The diagnosis of pemphigus was based on clinical, histologic, immunohistologic, and immunohistochemical criteria. The disease duration was 2-27 years (8.4 ± 7.2 years). Individuals with skin diseases other than pemphigus were selected as control subjects. Main outcome measure Information on drugs, foods, and occupational, environmental, constitutional, and other possible risk factors was analyzed by t-tests and chi-squared tests as applicable. A multivariate logistic regression model was applied to the data to study simultaneously the independent relationship between each risk factor and pemphigus vulgaris. Results The risk for pemphigus vulgaris was lower for ex-smokers and current smokers than for patients who had never smoked. Exposure to pesticides and occupational exposure to metal vapor were associated with an increased risk of pemphigus. Pemphigus patients had more pregnancies than controls. There were differences in environmental factors between countries, with exposure to gardening materials and pesticides being highest among patients from Bulgaria, followed by Israel. Disease characteristics also exhibited differences between countries. Bulgarian patients less frequently had oral mucous membrane lesions: 66% compared to 92% for Israeli patients and 83% for Italians. The distribution of the disease in skin and mucous membranes was similar among patients from all countries. Exclusive skin involvement was seen in 50% of patients, mucous membranes alone in 23% of patients, and both skin and mucous membranes in 27% of patients. Conclusions The beneficial effect of smoking on pemphigus might be explained by its effect on the immune system. In addition, smoking has an antiestrogenic effect, while pesticides have an estrogenic effect. The lower numbers of smokers among patients, the higher exposure rates to pesticides, and the higher number of female patients who had been pregnant may point to the contribution of estrogens to the disease process. It remains to be determined whether measures, such as avoiding exposure to pesticides or metal vapor, may be beneficial in the clinical context. As the present study was a survey, more definitive studies should be conducted to validate the results.

Revue / Journal Title

International journal of dermatology    ISSN  0011-9059   CODEN IJDEBB 

Source / Source

2001, vol. 40, no9, pp. 562-569 (49 ref.)

Langue / Language

Anglais

Editeur / Publisher

Blackwell , Oxford, ROYAUME-UNI  (1970) (Revue)

Mots-clés anglais / English Keywords

Skin disease

;

Bullous dermatosis

;

Immunopathology

;

Autoimmune disease

;

Epidemiology

;

Human

;

Questionnaire

;

Behavior

;

Food

;

Environment

;

Pemphigus vulgaris

;

Mots-clés français / French Keywords

Peau pathologie

;

Dermatose bulleuse

;

Immunopathologie

;

Maladie autoimmune

;

Epidémiologie

;

Homme

;

Questionnaire

;

Comportement

;

Aliment

;

Environnement

;

Pemphigus vulgaire

;

Mots-clés espagnols / Spanish Keywords

Piel patología

;

Dermatosis bulosa

;

Inmunopatología

;

Enfermedad autoinmune

;

Epidemiología

;

Hombre

;

Cuestionario

;

Conducta

;

Alimento

;

Medio ambiente

;

Pénfigo vulgar

;

Localisation / Location

INIST-CNRS, Cote INIST : 11580, 35400009999971.0030

Nº notice refdoc (ud4) : 14125549



Faire une nouvelle recherche
Make a new search
Lancer la recherche
Bas