{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:12:49Z","timestamp":1790061169646,"version":"4.0.1"},"reference-count":26,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Contemporary population\u2010based data on incidence trends and in\u2010hospital outcomes of pemphigus vulgaris remain limited, particularly in Southeast Asia. This study aimed to characterize incidence patterns and identify factors associated with severe in\u2010hospital 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\u2010year washout period. Crude and age\u2010standardized incidence rates were estimated, and temporal trends were evaluated using Poisson regression. Hospitalization analyses were restricted to index hospitalizations. Severe in\u2010hospital outcomes were defined as a composite of in\u2010hospital mortality, invasive mechanical ventilation, renal replacement therapy, or shock. Associations with severe in\u2010hospital 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\u2009000\u2009000 population. Incidence increased over time (adjusted incidence rate ratio 1.20; 95% CI 1.18\u20131.22), was higher with advancing age, and among females (female\u2010to\u2010male ratio 1.41:1). Increasing age\u2010standardized 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\u2010hospital outcomes. Acute kidney injury, malnutrition, and infection were associated with severe in\u2010hospital 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\u2010hospital outcomes. These findings support early identification of high\u2010risk patients and appropriate clinical management.<\/jats:p>","DOI":"10.1111\/1346-8138.70331","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T04:20:08Z","timestamp":1780114808000},"page":"1142-1152","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Incidence Trends and Severe in\u2010Hospital Outcomes of Pemphigus Vulgaris: A Nationwide Cohort Study"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5172-5250","authenticated-orcid":false,"given":"Rachot","family":"Wongjirattikarn","sequence":"first","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Faculty of Medicine Khon Kaen University  Khon Kaen Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumutnart","family":"Chanprapaph","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Faculty of Medicine, Ramathibodi Hospital Mahidol University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2051-5573","authenticated-orcid":false,"given":"Pawinee","family":"Rerknimitr","sequence":"additional","affiliation":[{"name":"Division of Dermatology, Department of Medicine, Faculty of Medicine, Center of Excellence for Skin and Allergy Research Chulalongkorn University  Bangkok Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6625-6445","authenticated-orcid":false,"given":"Leena","family":"Chularojanamontri","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Siriraj Hospital Mahidol University  Bangkok 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