{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T15:09:20Z","timestamp":1783004960063,"version":"3.54.5"},"reference-count":30,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,2,14]],"date-time":"2023-02-14T00:00:00Z","timestamp":1676332800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pemphigus is a potentially life\u2010threatening autoimmune blistering disease. To date, studies assessing the association of histopathology with clinical phenotype are lacking. We sought to evaluate the main histopathologic findings and, also, the potential links between cutaneous inflammatory infiltrates and clinical characteristics in pemphigus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a retrospective cohort study in patients diagnosed with pemphigus vulgaris (PV) and pemphigus foliaceus (PF) in a referral center for autoimmune blistering diseases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 124 patients were included in the study (97 had PV and 27 had PF). On biopsy specimens, PV was more frequently associated with the \u201crow of tombstones\u201d feature (36.1% vs. 11.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.013), and PF was associated with acanthosis (44.4% vs. 23.7%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.034). Acantholysis was found in the upper half of the epidermis in PF (96.3% vs. 5.15%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), as opposed to the lower half in PV (75.2% vs. 0%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.002).<\/jats:p><jats:p>Patients with lymphocyte\u2010predominant inflammatory infiltrates in lesional skin specimens presented with a higher frequency of the mucosal\u2010dominant phenotype (25.5% vs. 9.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014), higher\u2010density cellular infiltrate (100% vs. 41.6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and more frequent acantholytic cells (42.6% vs. 23.4%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.025). Neutrophil\u2010predominant infiltrates in specimens from lesional skin were linked to a milder disease based on median Pemphigus Disease Area Index (38.9% vs. 13.2%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.036) and Autoimmune Bullous Skin Disorder Intensity Score (20.2 vs. 36.3, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.019), while eosinophil\u2010predominant inflammatory infiltrates were more often associated with eosinophilic spongiosis (100% vs. 23.1%, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.014).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lymphocyte\u2010predominant infiltrates in lesional skin specimens of pemphigus patients predict a mucosal\u2010dominant phenotype, while neutrophil\u2010predominant infiltrates are associated with a milder disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.14395","type":"journal-article","created":{"date-parts":[[2023,1,21]],"date-time":"2023-01-21T12:54:05Z","timestamp":1674305645000},"page":"754-762","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Lymphocyte\u2010predominant lesional inflammatory infiltrates of the skin are associated with mucosal\u2010dominant phenotype in pemphigus"],"prefix":"10.1111","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7315-4711","authenticated-orcid":false,"given":"Cristian","family":"Papara","sequence":"first","affiliation":[{"name":"Department of Dermatology Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0968-4026","authenticated-orcid":false,"given":"Sorina","family":"Danescu","sequence":"additional","affiliation":[{"name":"Department of Dermatology Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Rogojan","sequence":"additional","affiliation":[{"name":"Department of Pathology County Emergency Hospital Cluj\u2010Napoca  Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel Corneliu","family":"Leucuta","sequence":"additional","affiliation":[{"name":"Department of Medical Informatics and Biostatistics Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeta","family":"Candrea","sequence":"additional","affiliation":[{"name":"Department of Dermatology Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Detlef","family":"Zillikens","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of L\u00fcbeck  L\u00fcbeck Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Baican","sequence":"additional","affiliation":[{"name":"Department of Dermatology Iuliu Hatieganu University of Medicine and Pharmacy  Cluj\u2010Napoca 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