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Risk Fact-ors | International Pemphigus Pemphigoid Foundation

Risk Fact-ors

The following riskfact”-ors are provided to clarify misconceptions about pemphigus and pemphigoid.

Pemphigus

  • Activities: none established as a risk
  • Pesticides: none known
  • Malignancy: For paraneoplastic pemphigus only: seen in patients with concurrent neoplasia, most often: non-Hodgkins Lymphoma, Chronic Lymphocytic Leukemia, and Castleman’s disease (m). Others include adenocarcinoma (pancreas and colon most common; also breast, prostate); hepatocellular carcinoma, squamous cell carcinoma, thymoma, Waldenstroms macoglobulinemia and others.
  • Drugs (see Table below)
  • Infection: unknown / not reported
  • Foods: no known foods are causally related.
    • Personne ne devrait éviter ces aliments, mais on peut envisager au cas par cas, comme certains patients rapport exacerbation de la maladie par certains groupes d'aliments contenant une ou plusieurs des quatre ingrédients: thiol, isothiocyanates, phénols ou des tanins.
    • Thiols: l'ail et les autres membres de l'Allium groupe qui contiennent des plantes telles que l'oignon, échalote, ciboulette et le poireau.
    • Isothiocyanates (huiles de moutarde): se trouvent dans 3200 espèces de plantes, y compris la moutarde, raifort, Cresson d'hiver, navet, brocoli, radis, Chou, choux de Bruxelles et de chou-fleur. Câpres. Huile synthétique de la moutarde.
    • Phénols: URUSHIOL peut causer des dermatites de contact et le trouve notamment dans poison ivy, chêne de poison et poison sumac qui sont liées à la mangue, pistaches et noix de cajou. L'aspartame édulcorant artificiel est phénoliques et commun dans de nombreux additifs alimentaires. Phénol est de cannelle et de l'acide cinnamique, et pinène. C'est dans les tomates, pommes de terre, mangues et bananes et lait et produits laitiers produits lorsque les vaches consomment phénol lacé des aliments comme les graines de coton.
    • Tanins: Sources communes de tanin sont les noix de kola, thé, café, framboise, Cherry, canneberge, BlackBerry, avocado, banane, Apple, mangue, poire, peaux d'aubergines et raisin, graines de café et le cacao, gingembre, Ginseng, ail, romarin, Arrow-root,.
  • Stress: no known relationship. Cependant, many patients report that stress (physical, physiological and psychological) exacerbates the disease.

 

Table 3:  Drugs associated with these conditions
Drugs associated with pemphigus vulgaris (n) Drugs associated with drug-induced bullous pemphigoid (n)
Captopril *, Enalapril, Cilazapril, Ramipril Ampicillin
Cephalosporins – cefadoxil and cephamandole, ceftazidime, ceftriaxone, cefuroxime, cephalexin Captopril*, Enalapril
Gold sodium thiomalate * Chloroquine
Interleukin Furosemide
Levodopa Penicillamine*
NSAIDs Penicillinsamoxil, ampicillin, penicillin, benyzylpenicllin
Penicillamine * Sulfapyridine
Penicillins – amoxil, ampicillin, pencillin, benyzylpenicllin Sulfasalazine
Phenobarbital PUVA: Psoralen with Ultraviolet A
Piroxicam  
Propranolol  
Pyritinol *  
Quinolones – nalidixic acid, lomafloxacin  
Rifamycinsrifampin  
Thioprine *  

*sulfur containing

Bulleuse

  • Age: increasing incidence with age.
  • Correlations between BP flare in disease activity and recurrence of underlying cancer suggest such an association in individual patients.

Myth and Lore

Myths associated with pemphigus and MMP

  • “they are old person’s diseases.” Mean age for PV is 40-60, for MMP is 40+.
  • “whether you receive treatment or not, these diseases are fatal.” (wrong)
  • “enhancing the immune system will cure pemphigus”(wrong)
  • “pemphigus and pemphigoid are curable diseases” (wrong – but long term remissions are seen; see later)
  • “alternative medicines will cure pemphigus” (not demonstrated)

 

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