Incidence Trends and Severe in-Hospital Outcomes of Pemphigus Vulgaris: A Nationwide Cohort Study
Issued Date
2026-01-01
Resource Type
ISSN
03852407
eISSN
13468138
Scopus ID
2-s2.0-105040389254
Journal Title
Journal of Dermatology
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Dermatology (2026)
Suggested Citation
Wongjirattikarn R., Chanprapaph K., Rerknimitr P., Chularojanamontri L., Choonhakarn C., Chaowattanapanit S., Anutraungkool T., Chaichaya N., Julanon N. Incidence Trends and Severe in-Hospital Outcomes of Pemphigus Vulgaris: A Nationwide Cohort Study. Journal of Dermatology (2026). doi:10.1111/1346-8138.70331 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/117101
Title
Incidence Trends and Severe in-Hospital Outcomes of Pemphigus Vulgaris: A Nationwide Cohort Study
Corresponding Author(s)
Other Contributor(s)
Abstract
Contemporary population-based data on incidence trends and in-hospital outcomes of pemphigus vulgaris remain limited, particularly in Southeast Asia. This study aimed to characterize incidence patterns and identify factors associated with severe in-hospital outcomes. We conducted a nationwide retrospective cohort study using Thailand's national administrative health database from 2015 to 2024. Incident cases were defined using a two-year washout period. Crude and age-standardized incidence rates were estimated, and temporal trends were evaluated using Poisson regression. Hospitalization analyses were restricted to index hospitalizations. Severe in-hospital outcomes were defined as a composite of in-hospital mortality, invasive mechanical ventilation, renal replacement therapy, or shock. Associations with severe in-hospital outcomes were evaluated using multivariable logistic regression, with sensitivity analyses accounting for repeated admissions using generalized estimating equations. A total of 2 542 incident adult cases were identified, corresponding to a mean annual incidence of 6.03 per 1 000 000 population. Incidence increased over time (adjusted incidence rate ratio 1.20; 95% CI 1.18–1.22), was higher with advancing age, and among females (female-to-male ratio 1.41:1). Increasing age-standardized incidence rates suggested that the temporal increase was not fully explained by population aging. This trend was accompanied by increasing annual hospitalizations. Among 1 537 index hospitalizations, 8.1% experienced severe in-hospital outcomes. Acute kidney injury, malnutrition, and infection were associated with severe in-hospital outcomes. In sensitivity analyses accounting for repeated admissions, advancing age and cardiovascular comorbidity were also associated with increased risk. Pemphigus vulgaris demonstrates a rising incidence beyond the effects of population aging, accompanied by increasing hospitalizations and a growing burden of severe in-hospital outcomes. These findings support early identification of high-risk patients and appropriate clinical management.