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Autoimmune Diseases
Volume 2013, Article ID 609181, 4 pages
Clinical Study

Anal Involvement in Pemphigus Vularis

1Autoimmune Bullous Diseases Research Center, Department of Dermatology, Tehran University of Medical Sciences, Razi Hospital, Vahdate-Eslami Square, Tehran 11996, Iran
2Knowledge Utilization Research Center, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613151, Iran

Received 29 June 2013; Accepted 19 September 2013

Academic Editor: Paulo Ricardo Criado

Copyright © 2013 Somayeh Khezri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Pemphigus vulgaris (PV) is an autoimmune blistering disease of the skin and mucosa. Anal mucosa may be involved in PV, but the frequency and clinical profile are not fully ascertained. Objective. The aim was to investigate the involvement of the anal area in newly diagnosed PV patients. Patients and Methods. A total of 168 consecutive newly diagnosed PV patients were enrolled. Anal symptoms and signs, involvement of other body sites, and severity of disease were recorded. Results. A total of 47 out of 168 patients (27.9%) had involvement of the anal area. Anal involvement was significantly associated with PV lesions in ophthalmic ( ), nasal ( ), and genital mucosa ( ) but not the oral cavity ( ). There was a significant association between number of involved mucosal sites and anal involvement ( ). Anal involvement was associated with oral severity ( ). Constipation was the most frequent symptom (73.8%) followed by pain on defecation (50%). Seventeen patients (36%) were symptom-free. Erosion was the most frequent sign (91.5%). Conclusion. Anal involvement in PV seems to be more frequent than previously assumed. Routine anal examination is recommended even in asymptomatic patients as anal involvement appears to correlate with the severity of PV.