Associations Between Pemphigus and Type 1 Diabetes, Type 2 Diabetes

The following article is part of coverage from the American Academy of Dermatology’s Annual Meeting (AAD 2020). Because of concerns regarding the coronavirus disease 2019 (COVID-19) pandemic, all AAD 2020 sessions and presentations were transitioned to a virtual format. While live events will not proceed as planned, readers can click here to view more news related to research presented during the AAD VMX 2020 virtual experience.

Pemphigus disorders are significantly associated with type 2 diabetes (T2D) but not with type 1 diabetes (T1D), according to study results presented at the American Academy of Dermatology’s Virtual Meeting Experience (AAD VMX) 2020, held online from June 12 to 14, 2020.

Given that pemphigus has an autoimmune etiology, researchers conducted a systematic review and meta-analysis to characterize the associations between pemphigus and T1D or T2D. A total of 5 studies met the criteria for inclusion.

Results of the meta-analysis showed that pemphigus was significantly associated with T2D (odds ratio, 2.32; 95% CI, 1.24-4.33; P =.008; I2 =93%). Conversely, no association was found between pemphigus and T1D (odds ratio, 1.88; 95% CI, 0.38-9.4; P =.33; I2 =71%).

“The auto-inflammatory phenotype implicated in pemphigus…[is] also implicated in [rheumatoid arthritis] and autoimmune thyroid disorders. However, auto-inflammatory mechanisms in [T1D] are not related and may explain the lack of association with pemphigus,” noted the study authors.

“Clinicians should be aware of the association of pemphigus with [T2D] and not [T1D],” they suggested, adding that screening for pemphigus in patients with T2D may reduce poor outcomes. Further research is needed to understand the pathophysiology of this association.

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Phan K, Smith SD. Pemphigus and diabetes mellitus: systematic review and meta-analysis. Presented at: AAD VMX 2020; June 12-14, 2020. Poster 13999.