Pemphigus Associated with Psoriasis Vulgaris: A Retrospective Study of Seven Patients and a Review of the Literature.

The aim of this study was to analyze the characteristics and the treatment for patients with psoriasis who presented with subsequent pemphigus after their treatment. A retrospective study of seven patients with psoriasis associated with pemphigus was performed, including the clinical assessment and treatments. The patients with a median age of 74 (range from 54 to 85) were significantly older than those in previously reported cases, where the median age was 58 (range from 15 to 77) (P<0.05). Six out of seven patients were male, which represents a higher ratio than that reported in literature (10/20). The duration between the diagnosis of psoriasis and onset of pemphigus ranged from 4 to 30 years, and previous studies reported a much wider range that, from a few months to 52 years. Patients developed pemphigus after the treatments for psoriasis with ultraviolet light, steroids, or immunosuppressant. Our study represents a distinct subset of patients with psoriasis accompanied with pemphigus who share typical clinical characteristics. Among these patients, most are elderly men and the dominant subtype is pemphigus foliaceus. Our data suggests that no treatment for psoriasis specifically correlated with the development of pemphigus. The combination treatment of steroids with immunosuppressant lead to an improvement of the disease.