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Timóteo RP, Pessoa-Gonçalves YM, do Carmo Neto JR, Rodrigues WF, da Silva MV, Oliveira CJF. A Global View of Pemphigus: Geographical Variations. Clin Rev Allergy Immunol 2024; 66:14-29. [PMID: 38289514 DOI: 10.1007/s12016-024-08980-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 03/28/2024]
Abstract
Pemphigus, an autoimmune intraepidermal bullous disease group with roughly eight distinct forms, includes pemphigus vulgaris (PV) and pemphigus foliaceus (PF) as its predominant global forms. Despite the increased utilization of global health records and reporting systems, epidemiological data remain limited and poorly categorized. Therefore, this study aimed to conduct a review to track, identify, and characterize cases of PV and PF published and categorized worldwide. A research question was formulated; studies were selected based on the inclusion criteria; and data from these publications were systematically collected, summarized, and presented using narrative descriptions. The search strategy yielded 3,212 articles, of which 95 underwent critical analysis and data extraction. Studies from 52 countries contributed to the dataset, covering various pemphigus variants. Notably, only two countries, Iran (18.87%) and South Korea (11.43%), accounted for approximately a third of the reported PV cases, while Brazil contributed 40.25% of the foliaceus variants cases documented in the literature. These findings offer valuable insights into the global distribution of pemphigus and inform future research and healthcare efforts.
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Affiliation(s)
- Rodolfo Pessato Timóteo
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, 38025-180, Brazil
| | - Yago Marcos Pessoa-Gonçalves
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, 38025-180, Brazil
| | - José Rodrigues do Carmo Neto
- Department of Bioscience and Technology, Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiania, Goiás, 74690-900, Brazil
| | - Wellington Francisco Rodrigues
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, 38025-180, Brazil
| | - Marcos Vinícius da Silva
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, 38025-180, Brazil
| | - Carlo José Freire Oliveira
- Department of Microbiology, Immunology and Parasitology, Institute of Biological and Natural Sciences, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, 38025-180, Brazil.
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Popescu IA, Vata D, Temelie Olinici D, Tarcau BM, Patrascu AI, Halip IA, Gugulus DL, Mocanu M, Gheuca Solovastru L. Epidemiological Study of Autoimmune Bullous Dermatoses in Northeastern Romania. Diagnostics (Basel) 2023; 14:57. [PMID: 38201366 PMCID: PMC10871116 DOI: 10.3390/diagnostics14010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 12/19/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Autoimmune bullous diseases (ABDs) are a rare but significant group of dermatoses that pose great challenges to the treating dermatologist. ABDs are characterized by the presence of tissue-bound and circulating autoantibodies directed against disease-specific target antigens of the skin. Most epidemiological studies have focused on a single ABD. More than that, there are few data about the incidence and prevalence of autoimmune blistering diseases in Romania. METHODS In this study, between 2015 and 2019, we retrospectively investigated a total of 225 patients with autoimmune bullous diseases from the northeastern region of Romania. The diagnosis was based on the clinical and histo- and immunohistological findings. RESULTS Pemphigus was the most frequently encountered ABD, with an incidence of 8.16/1,000,000 inhabitants, representing 58.7% (132 cases), followed by 24% cases of bullous pemphigoid (54 cases), 15.4% of patients were diagnosed with dermatitis herpetiformis (37 cases), and 0.9% other subepidermal autoimmune bullous dermatoses. The average age of onset of pemphigus vulgaris was 59.4 years, the majority of patients being male, while the average age of patients diagnosed with bullous pemphigoid was 73.8 years, the majority being female. CONCLUSIONS Pemphigus vulgaris is the most frequently encountered ABDs in the northeast of Romania, with a higher incidence than in Western European countries, and this may be due to specific peculiarities of the geographical area, as well as to a genetic susceptibility of the population in this region.
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Affiliation(s)
- Ioana Adriana Popescu
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dan Vata
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Doinita Temelie Olinici
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Bogdan Marian Tarcau
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Adriana Ionela Patrascu
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ioana Alina Halip
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Dumitrita Lenuta Gugulus
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Madalina Mocanu
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Laura Gheuca Solovastru
- “Saint Spiridon” County Emergency Clinical Hospital, 700111 Iasi, Romania; (I.A.P.); (D.T.O.); (A.I.P.); (I.A.H.); (D.L.G.); (M.M.); (L.G.S.)
- “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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Kronzer VL, Kimbrough BA, Crowson CS, Davis JM, Holmqvist M, Ernste FC. Incidence, Prevalence, and Mortality of Dermatomyositis: A Population-Based Cohort Study. Arthritis Care Res (Hoboken) 2023; 75:348-355. [PMID: 34549549 PMCID: PMC8934743 DOI: 10.1002/acr.24786] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/07/2021] [Accepted: 09/14/2021] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We aimed to determine the population-based incidence, prevalence, and mortality of dermatomyositis (DM) using European Alliance of Associations for Rheumatology (EULAR)/American College of Rheumatology (ACR) criteria. METHODS This population-based cohort study included incident DM from January 1, 1995 to December 31, 2019. We manually reviewed all individuals with at least 1 code for DM or polymyositis to determine if they met EULAR/ACR criteria, subspecialty physician diagnosis, and/or Bohan and Peter criteria. We age- and sex-adjusted incidence and prevalence estimates to the US non-Hispanic White year 2000 population and estimated prevalence on January 1, 2015. Standardized mortality ratios (SMRs) with 95% confidence intervals (95% CIs) compared observed to expected mortality adjusting for age, sex, and year. RESULTS We identified 40 cases of verified DM, with 29 cases incident in Olmsted County from 1995 to 2019. The mean age was 57 years, 26 (90%) were female, and 12 (41%) had clinically amyopathic DM (CADM). The median follow-up time was 8.2 years. The overall adjusted incidence of DM was 1.1 (95% CI 0.7-1.5) per 100,000 person-years, and prevalence was 13 (95% CI 6-19) per 100,000. The SMR was significantly elevated among the myopathic DM cases (3.1 [95% CI 1.1-6.8]) but not CADM cases (1.1 [95% CI 0.2-3.3]). The positive predictive value of ≥2 DM codes was only 40 of 82 (49%). CONCLUSION This population-based study found that DM incidence and prevalence were higher than previously reported. Mortality was significantly elevated for myopathic DM but not for CADM.
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Affiliation(s)
| | | | - Cynthia S. Crowson
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - John M. Davis
- Division of Rheumatology, Mayo Clinic, Rochester, Minnesota, USA
| | - Marie Holmqvist
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Sethomo W, Williams VL, Tladi P, Gabaitiri L, Mazhani L, Steenhoff AP, Kovarik C. Skin conditions among pediatric dermatology outpatients in Botswana. Pediatr Dermatol 2022; 39:883-888. [PMID: 35761771 DOI: 10.1111/pde.15066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 05/21/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND An understanding of the prevalence patterns of skin diseases in children in Botswana is needed to guide national dermatological policy development, training, and resource allocation to improve patient care. OBJECTIVE To describe local skin disease patterns in children aged 0-18 years presenting for dermatologic care in Botswana. METHODS A retrospective review of records from 1st January 2011 to 31st December 2016 was conducted at the outpatient dermatology clinic of Princess Marina Hospital (PMH) in Gaborone, Botswana and outreach clinic sites. RESULTS There were 4413 pediatric visits constituting 18.6% of all dermatology visits. There was a slight male predominance of 1.2:1. The majority of disorders were noninfectious 80.1% (3537/4413) versus infectious 14.6% (645/4413), with 5.2% (231/4413) unclassified. In the noninfectious category, two-thirds were inflammatory, followed by disorders of nails, skin appendages, and pigmentary disorders. Atopic dermatitis was the most common inflammatory disorder. Over half of infectious skin diseases were viral, followed by fungal and bacterial disorders. In the HIV-related disorders, the majority were verrucae 94% (108/115) followed by Kaposi sarcoma. The nine most common skin diagnoses accounted for close to 70% of all skin diseases seen at the clinic, and these included atopic dermatitis (almost half of all cases), followed by verruca, acne, and vitiligo. CONCLUSION There is a high burden of skin disorders in children in Botswana. In our cohort, a small number of skin conditions made up the vast majority of pediatric diagnoses. This information can be used to guide dermatology training and resource allocation to better manage these common diseases.
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Affiliation(s)
- Warona Sethomo
- Ministry of Health and Wellness, Headquarters, Gaborone, Botswana.,University of Botswana, Gaborone, Botswana
| | - Victoria L Williams
- Ministry of Health and Wellness, Headquarters, Gaborone, Botswana.,University of Botswana, Gaborone, Botswana.,Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Botswana-UPenn Partnership, Gaborone, Botswana.,Merck & Co., Inc., Upper Gwynedd, Pennsylvania, USA
| | | | | | | | - Andrew P Steenhoff
- University of Botswana, Gaborone, Botswana.,Botswana-UPenn Partnership, Gaborone, Botswana.,Global Health Center, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Carrie Kovarik
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Botswana-UPenn Partnership, Gaborone, Botswana
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Chung JG, Ramji R, Coomarasamy C, Jarrett P, Rademaker M, Patel DC. Bullous pemphigoid: Its incidence, mortality and clinical outcome in New Zealand. Australas J Dermatol 2022; 63:197-203. [PMID: 35324003 DOI: 10.1111/ajd.13822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 02/26/2022] [Accepted: 03/03/2022] [Indexed: 01/08/2023]
Abstract
BACKGROUND/OBJECTIVES Bullous pemphigoid (BP) is an uncommon autoimmune bullous disorder, with significant morbidity and mortality. Mortality may be as high as 23.5% in the first year after diagnosis. Clear epidemiologic data across Australasia are lacking. METHODS A retrospective, multi-centred cohort study was designed to determine the incidence and mortality of bullous pemphigoid in New Zealand. Data from all histopathologically diagnosed patients with bullous pemphigoid between 2009 and 2015 from the Auckland region were obtained. Demographics, clinical characteristics and outcome 3 years from diagnosis (until 31 December 2018) were collected. Demographic data were compared against a denominator year-matched New Zealand Census population. RESULTS One hundred sixty-one patients had confirmed bullous pemphigoid, with an incidence rate of 3.03/100 000 person-years [95% CI 2.58-3.54]; 70% were of European ethnicity; 12.4% were Pacific peoples; 11.2% were Asian; and 6.8% were Māori. 45.3% had associated cognitive impairment and/or stroke. In the 3-year follow-up, 25% had treatment complications mostly from prednisone therapy. The mortality rate was 40%, highest in the first year of diagnosis, with age at diagnosis a predictor. CONCLUSION The incidence and mortality rates are comparable to the UK/Northern Europe. Knowledge of the epidemiology of bullous pemphigoid in New Zealand and within an international settling informs the provision of future care and treatments.
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Affiliation(s)
- Jenny G Chung
- Department of Dermatology, Counties Manukau Health, Auckland, New Zealand.,Department of Dermatology, Auckland District Health Board, Auckland, New Zealand
| | - Rajan Ramji
- Department of Medicine, The University of Auckland, Auckland, New Zealand
| | - Christin Coomarasamy
- Ko Awatea, Research and Evaluation Office, Counties Manukau Health, Auckland, New Zealand
| | - Paul Jarrett
- Department of Dermatology, Counties Manukau Health, Auckland, New Zealand.,Department of Medicine, The University of Auckland, Auckland, New Zealand
| | - Marius Rademaker
- Department of Medicine, The University of Auckland, Auckland, New Zealand
| | - Denesh C Patel
- Department of Medicine, The University of Auckland, Auckland, New Zealand.,Department of Dermatology, Auckland District Health Board, Auckland, New Zealand
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Essouma M, Noubiap JJ, Singwe-Ngandeu M, Hachulla E. Epidemiology of Idiopathic Inflammatory Myopathies in Africa: A Contemporary Systematic Review. J Clin Rheumatol 2022; 28:e552-e562. [PMID: 33843773 DOI: 10.1097/rhu.0000000000001736] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The epidemiology of idiopathic inflammatory myopathies (IIMs) has been extensively studied in America, Europe, and Asia, but remains unclear in Africa. OBJECTIVE The aim of this review was to summarize available data on the epidemiology of IIMs in Africa. METHODS We searched MEDLINE, EMBASE, and African Journals Online for studies published up to December 30, 2020, and reporting epidemiological data on IIMs in Africa. Data were combined through narrative synthesis. The review protocol was registered with PROSPERO, CRD42020186781. RESULTS We included 39 studies reporting 683 cases (71.7% adults) of IIMs. Incidence rates of ~7.5/1,000,000 person-years and 1.2/1,000,000 person-years were estimated for dermatomyositis (DM), whereas polymyositis (PM) had an incidence rate of 8.8/1,000,000 person-years. Prevalence estimates of 11.49/100,000 and 11/100,000 (95% confidence interval, 0-32) were provided for IIMs and the PM subtype, respectively. Mean age at diagnosis ranged from 7.9 to 57.2 years, and 50% to 100% of the patients were females. Main subtypes of adult-onset IIMs were DM (21%-93%) and PM (12%-79%), whereas the commonest juvenile subtype was juvenile DM (5.8%-9%). Skeletal muscle involvement (56%-100%) was the main disease feature, and esophagus was the most commonly affected internal organ (6%-65.2%). Anti-Jo1/histidyl tRNA synthetase (7%-100%) and anti-Mi2 (17%-45%) antibodies were the most frequent myositis specific antibodies. Early mortality was high (7.8%-45%), and main death causes were infections, cancers and organ damage in respiratory and cardiovascular domains. CONCLUSIONS Apart from a potential younger age at onset of adult IIMs in Africa, current sparse data mostly suggest a similar epidemiology between Africa and other regions. Further high-quality studies are required to validate these findings.
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Affiliation(s)
| | - Jean Jacques Noubiap
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | | | - Eric Hachulla
- Department of Internal Medicine and Clinical Immunology, CHRU Lille, Referral Centre for rare systemic autoimmune diseases North and Northwest of France, Univ. Lille, INSERM U995, LIRIC-Lille Inflammation Research International Centre, Lille, France
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Lu L, Chen L, Xu Y, Liu A. Global Incidence and Prevalence of Bullous Pemphigoid: a Systematic Review and meta-analysis. J Cosmet Dermatol 2022; 21:4818-4835. [PMID: 35080093 DOI: 10.1111/jocd.14797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Integrated information on the global prevalence and incidence of bullous pemphigoid (BP) is lacking. OBJECTIVE To estimate the incidence and prevalence of BP in a systematic review and meta-analysis. METHODS Observational studies were included by using databases of Medline, EMBASE and Cochrane Library. Subgroup analysis was by continent, age, sex and country income level. Random-effects model was used. Between-study heterogeneity was assessed using the I2 statistic. RESULTS The global incidence was 0.0419 per 1000 person-years (95% CI: 0.0414-0.0424). The incidence was 0.047 per 1000 person-years (95% CI: 0.0462-0.0477), 0.0419 per 1000 person-years (95% CI: 0.0411-0.0426), 0.0072 per 1000 person-years (95% CI: 0.0067-0.0078), 0.003 per 1000 person-years (95% CI: 0.0023-0.0039) in North America, Europe, Asia and Africa, respectively; 0.0202 per 1000 person-years (95% CI: 0.0196; 0.0208) and 0.0181 per 1000 person-years (95% CI: 0.0175; 0.0188) females and males; 0.001 per 1000 person-years (95% CI: 0.001-0.001), 0.002 per 1000 person-years (95% CI:0.001-0.002), 0.004 per 1000 person-years (95% CI: 0.004-0.004); 0.007 per 1000 person-years (95% CI: 0.007-0.008), 0.011 per 1000 person-years (95% CI: 0.011-0.012), 0.017 per 1000 person-years (95% CI: 0.015-0.018) for age < 50, 50-59, 60-69, 70-79, 80-89 and ≥90 years. 0.0038 per 1000 person-years (95% CI:0.0036-0.004112) (I2 = 99%, p<.05) and 0.0456 per 1000 person-years (95% CI:0.0450-0.0462) (I2 = 100%, p<.05). The pooled clinic-based prevalence was 0.79 % (95% CI: 0.75%-0.84%), and 1.13% (95% CI: 1.06%-1.21%), 0.21% (95% CI: 0.17%-0.26%), 0.13% (95% CI:0.1%-0.15%) for Asia, Africa and Europe. CONCLUSIONS This study identified the global incidence and prevalence of BP in terms of spatial and population distributions and among various income level. A relatively higher incidence was in Europe, females, older people and high-income level country. The prevalence was higher in Asia. These findings should be interpreted with caution due to high heterogeneity of included studies.
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Affiliation(s)
- Lingling Lu
- Henan University of Chinese Medicine, Zhengzhou, P.R. China
| | - Linjiao Chen
- Department of dermatology, Shenzhen Hospital, Beijing University of Chinese Medicine (Longgang), Shenzhen, P.R.China
| | - Yujuan Xu
- Department of Gynae Cology and Obstetrics, Changshu Hospital of Chinese Medicine, Suzhou, P.R.China
| | - Aimin Liu
- Department of Dermatology, Henan Province Hospital of Traditional Chinese Medicine, The Second Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, P.R.China
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Persson MSM, Begum N, Grainge MJ, Harman KE, Grindlay D, Gran S. The global incidence of bullous pemphigoid: a systematic review and meta-analysis. Br J Dermatol 2021; 186:414-425. [PMID: 34480482 DOI: 10.1111/bjd.20743] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND Bullous pemphigoid (BP) is an autoimmune blistering disorder that mainly affects older people. Although the disease is associated with considerable morbidity and mortality, the burden of disease worldwide is unclear. OBJECTIVES The study aim is to pool the global incidence of BP and determine whether this varies according to geographic area, age group, setting and study quality. METHODS Ovid MEDLINE, Ovid Embase and grey literature were systematically searched on 7 April 2020. Two reviewers independently screened, extracted data and appraised each study's quality using the Joanna Briggs Institute critical appraisal tool. Two domains, indicative of selection and survey bias, were used to identify high-quality studies. The cumulative incidence was standardized to 1 year and pooled in a random-effects meta-analysis. Subgroup and sensitivity analyses were conducted. RESULTS Twenty-seven studies were identified, of which 23 provided cumulative incidence and four provided incidence rates. The cumulative incidence of BP was 8·2 [95% confidence interval (CI) 4·8-13.7] per million people whereas the incidence rate was 34·2 (95% CI 19·2-60·7) per million person-years. Of the continents that contributed more than one study, the cumulative incidence was 10·3 (95% CI 5·8-18·2) and 5·6 (95% CI 3·5-9·0) per million people in Europe and Asia, respectively. The incidence was highest in studies including adults only (n = 2), in population-based studies (n = 9) and in more recent years. The cumulative incidence was higher (13·3 per million people, 95% CI 6·0-29·5) when restricting the analysis to higher-quality studies (n = 11). High heterogeneity (I2 > 82%) was observed across all pooled estimates. CONCLUSIONS The incidence of BP varies globally, is generally low but appears to be increasing over time. The burden of disease is likely to be underestimated.
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Affiliation(s)
| | - N Begum
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - M J Grainge
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - K E Harman
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - D Grindlay
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - S Gran
- School of Medicine, Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
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Bairkdar M, Rossides M, Westerlind H, Hesselstrand R, Arkema EV, Holmqvist M. Incidence and prevalence of systemic sclerosis globally: a comprehensive systematic review and meta-analysis. Rheumatology (Oxford) 2021; 60:3121-3133. [PMID: 33630060 PMCID: PMC8516513 DOI: 10.1093/rheumatology/keab190] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/14/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES We aimed to conduct a systematic review and meta-analysis on the incidence and prevalence of SSc covering the entire literature. METHODS This study followed the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement of 2009. We conducted a systematic search in MEDLINE, Web of Science and Embase to identify articles reporting incidence and/or prevalence of SSc. Two authors conducted the search, reviewed articles for inclusion and extracted relevant data. We used random-effects models to estimate the pooled prevalence and incidence of SSc and performed subgroup analyses by sex, case definition and region to investigate heterogeneity. We explored the association between calendar period and reported estimates using meta-regression. RESULTS Among 6983 unique records identified, we included 61 studies of prevalence and 39 studies of incidence in the systematic review. The overall pooled prevalence of SSc was 17.6 (95% CI 15.1, 20.5) per 100 000 and the overall pooled incidence rate of SSc was 1.4 (95% CI 1.1, 1.9) per 100 000 person-years. We observed significant regional variations in reported estimates; studies conducted in North America reported considerably higher estimates than other regions. The pooled incidence and prevalence in women were five times higher than in men. More recent studies reported higher estimates than older ones. CONCLUSION In this comprehensive review of the incidence and prevalence of SSc across the world, there was large heterogeneity among estimates, which should be taken into consideration when interpreting the results.
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Affiliation(s)
- Majd Bairkdar
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Marios Rossides
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Helga Westerlind
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Roger Hesselstrand
- Section for Rheumatology, Department of Clinical Sciences Lund, Lund University and Skåne University Hospital, Lund
| | - Elizabeth V Arkema
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - Marie Holmqvist
- Division of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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Kridin K, Schmidt E. Epidemiology of Pemphigus. JID INNOVATIONS 2021; 1:100004. [PMID: 34909708 PMCID: PMC8659392 DOI: 10.1016/j.xjidi.2021.100004] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 01/01/2023] Open
Abstract
Pemphigus is an epidemiologically heterogeneous group of autoimmune bullous diseases comprising pemphigus vulgaris (PV), pemphigus foliaceus, paraneoplastic pemphigus, IgA pemphigus, and pemphigus herpetiformis. Recently, our knowledge about the frequency of pemphigus, which is highly variable between different populations, has considerably expanded, and the first non-HLA genes associated with PV have been identified. In addition, a variety of comorbidities, including other autoimmune diseases, hematological malignancies, and psoriasis, have been described in this variant. Here, initial data about the impact of COVID-19 on this fragile patient population are discussed and perspectives for future epidemiological studies are outlined.
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Key Words
- ACE, angiotensin-converting enzyme
- AIBD, autoimmune bullous disease
- CAAR, chimeric autoantibody receptor
- CI, confidence interval
- DSG, desmoglein
- EADV, European Academy of Dermatology and Venereology
- EC, extracellular
- EMA, European Medicines Agency
- FS, fogo selvage
- HR, hazard ratio
- ICD, International Classification of Diseases
- PF, pemphigus foliaceus
- PNP, paraneoplastic pemphigus
- PV, pemphigus vulgaris
- SMR, standardized mortality ratio
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Affiliation(s)
- Khalaf Kridin
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- The Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Enno Schmidt
- Lűbeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
- Department of Dermatology, University of Lübeck, Lübeck, Germany
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Vento S, Cainelli F. Commentary: Systemic Lupus Erythematosus in Native sub-Saharan Africans: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2020; 7:202. [PMID: 32537453 PMCID: PMC7267008 DOI: 10.3389/fmed.2020.00202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/27/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sandro Vento
- Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia
- *Correspondence: Sandro Vento ;
| | - Francesca Cainelli
- Faculty of Medicine, University of Puthisastra, Phnom Penh, Cambodia
- Raffles Medical Group Clinic, Phnom Penh, Cambodia
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Ji Y, Mei X, Wei F, Liu S, Ji Y. A secondary discoid lupus erythematosus induced by scald of edible oil: An illustration of Koebner phenomenon. J Cosmet Dermatol 2019; 19:1699-1701. [PMID: 31660688 DOI: 10.1111/jocd.13189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Accepted: 09/25/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Yong‐Zhi Ji
- Department of Dermatology Second Hospital of Ji Lin University Changchun China
| | - Xiang‐Lin Mei
- Department of Pathology Second Hospital of Ji Lin University Changchun China
| | - Fang‐Li Wei
- Department of Dermatology Affiliated Hospital of Tai'an Medical College Tai'an China
| | - Shi‐Rui Liu
- Department of Dermatology Second Hospital of Ji Lin University Changchun China
| | - You‐Bo Ji
- Pain Department Second Hospital of Ji Lin University Changchun China
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Tran DA, Tan X, Macri CJ, Goldstein AT, Fu SW. Lichen Sclerosus: An autoimmunopathogenic and genomic enigma with emerging genetic and immune targets. Int J Biol Sci 2019; 15:1429-1439. [PMID: 31337973 PMCID: PMC6643151 DOI: 10.7150/ijbs.34613] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 04/10/2019] [Indexed: 12/14/2022] Open
Abstract
Lichen sclerosus (LS) is an inflammatory dermatosis with a predilection for anogenital skin. Developing lesions lead to vulvar pain and sexual dysfunction, with a significant loss of structural anatomical architecture, sclerosis, and increased risk of malignancy. Onset may occur at any age in both sexes, but typically affects more females than males, presenting in a bimodal fashion among pre-pubertal children and middle-aged adults. A definitive cure remains elusive as the exact pathogenesis of LS remains unknown. A general review of LS, histologic challenges, along with amounting support for LS as an autoimmune disease with preference for a Th1 immune response against a genetic background is summarized. In addition to the classically referenced ECM1 (extracellular matrix protein 1), a following discussion of other immune and genetic targets more recently implicated as causative or accelerant agents of disease, particularly miR-155, downstream targets of ECM1, galectin-7, p53, and epigenetic modifications to CDKN2A, are addressed from the viewpoint of their involvement in three different, but interconnected aspects of LS pathology. Collectively, these emerging targets serve not only as inherently potential therapeutic targets for treatment, but may also provide further insight into this debilitating and cryptic disease.
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Affiliation(s)
- Davis A. Tran
- Department of Medicine (Division of Genomic Medicine), and Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Xiaohui Tan
- Department of Medicine (Division of Genomic Medicine), and Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Charles J. Macri
- Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Andrew T. Goldstein
- Department of Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC
- Center for Vulvovaginal Disorders, Washington, DC
| | - Sidney W. Fu
- Department of Medicine (Division of Genomic Medicine), and Department of Microbiology, Immunology and Tropical Medicine, The George Washington University School of Medicine and Health Sciences, Washington, DC
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