{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T01:38:35Z","timestamp":1789609115554,"version":"build-2803163510"},"reference-count":36,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001700","name":"Ministry of Education, Culture, Sports, Science and Technology","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001700","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003478","name":"Ministry of Health, Labour and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003478","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pemphigus is a life\u2010threatening autoimmune blistering disease. Patient characteristics, treatment courses, and outcomes remain unclear owing to its rarity. To describe the background, treatment, and outcomes of pemphigus, we identified 2598 patients with pemphigus vulgaris and 1186 patients with pemphigus foliaceus from a nationwide inpatient database in Japan. Patients with pemphigus vulgaris were younger (62 vs 72\u2009years, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001), had fewer comorbidities, and were more likely to be admitted to high\u2010volume hospitals (38% vs 30%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) than those with pemphigus foliaceus. Patients with pemphigus vulgaris had undergone more aggressive treatment, including steroid pulse therapy, intravenous immunoglobulin, or plasmapheresis, compared with those with pemphigus foliaceus (48% vs 42%, <jats:italic>P<\/jats:italic>\u00a0=\u20090.001); specifically, in patients aged &lt;70\u2009years, the pemphigus vulgaris group was more likely to undergo aggressive treatment than the pemphigus foliaceus group (52% vs 45%), whereas there was no significant difference in patients aged \u226570\u2009years (40% vs 40%). Immunosuppressive agents (30% vs 26%, <jats:italic>P<\/jats:italic>\u00a0=\u20090.015) and analgesics, including opioids (45% vs 36%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001), were used more frequently, whereas topical corticosteroids were used less frequently (32% vs 48%, <jats:italic>P<\/jats:italic>\u00a0&lt;\u20090.001) in patients with pemphigus vulgaris compared with those with pemphigus foliaceus. In\u2010hospital mortality was lower in patients with pemphigus vulgaris than in those with pemphigus foliaceus (2.2% vs 4.0%, <jats:italic>P<\/jats:italic>\u00a0=\u20090.002); in the comparison stratified by age, the mortality was equivalent among the two groups (0.6% in patients aged &lt;70\u2009years and 6.1% in those aged \u226570\u2009years). Overall, patients with pemphigus vulgaris had a 10\u2010day longer hospitalization period and higher hospitalization costs than those with pemphigus foliaceus. Our findings provide useful information for understanding the current trends in the management of pemphigus in Japan.<\/jats:p>","DOI":"10.1111\/1346-8138.16641","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T07:19:30Z","timestamp":1669360770000},"page":"212-221","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Clinical course and outcomes of pemphigus vulgaris and foliaceus: A retrospective study using a nationwide database in Japan"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2549-6690","authenticated-orcid":false,"given":"Hideaki","family":"Miyachi","sequence":"first","affiliation":[{"name":"Department of Dermatology, Graduate School of Medicine Chiba University  Chiba 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