Pemphigus in black South Africans in the Johannesburg area

Abstract

The purpose of this study .was to investigate the prevalence of pemphigus in the black population in the Johannesburg area. Over a period of 8 years (1987-1995) 35 cases of pemphigus were diagnosed at the Baragwanath Hospital They constituted approximately 0,3% of new dermatological patients seen during this time.

In each patient the diagnosis of pemphigus was confirmed by skin biopsies taken for both histological and immunofluorescence studies. Of the 35 cases, pemphigus foliaceus was diagnosed in 17 (48,6 %) and pemphigus vulgaris in 15 (42,9%). Pemphigus erythematosus was diagnosed in two cases (5,7%) and pemphigus vegetans in one (2,8%). The histological findings were diagnostic in 21 (60%) but equivocal in 14 (40%) cases. AH cases had positive immunofluorescence. Direct immunofluorescence with IgG was positive in 91,4 % and C3 in 60%. In 14,7% o f patients IgG alone was positive and in 20,6% both IgG andd C3 were positive. Indirect immunofluorescence was positive in 60% of patients.