Clinical and immunological features of pemphigus relapse

Abstract

BACKGROUND: More than half of patients with pemphigus experience relapse during the disease course. The risk factors and clinical and immunological characteristics of relapse remain largely unclear. OBJECTIVES: To elucidate the risk factors and clinical features of pemphigus relapse. METHODS: We carried out a retrospective review of the clinical records of 42 cases of pemphigus at a single centre. RESULTS: ). At relapse, mcPV shifted to mucosal dominant PV (mPV; 40%), pemphigus foliaceus (PF) (20%) or 'other' (20%). In contrast, relapsing mPV and PF had the same clinical phenotypes as the initial phenotypes. Patients with both anti-desmoglein (Dsg)1 and anti-Dsg3 antibodies at onset had recurrence with anti-Dsg3 antibodies alone (40%), with both anti-Dsg1 and anti-Dsg3 antibodies (30%), with anti-Dsg1 antibody alone (20%) or were subthreshold (10%). CONCLUSIONS: may lead to better outcomes.