Risk of Osteoporosis Associated with Glucocorticoid Use in Pemphigus Vulgaris: Insights from a Retrospective Cohort Study
Dermatology Practical and Conceptual, cilt.15, sa.2, 2025 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 15 Sayı: 2
- Basım Tarihi: 2025
- Doi Numarası: 10.5826/dpc.1502a5050
- Dergi Adı: Dermatology Practical and Conceptual
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Directory of Open Access Journals
- Anahtar Kelimeler: bone loss, bone mineral density, corticosteroid-induced osteoporosis, glucocorticoids, osteoporosis, pemphigus vulgaris, retrospective cohort
- Ankara Yıldırım Beyazıt Üniversitesi Adresli: Evet
Özet
Introduction: Pemphigus vulgaris (PV) is an autoimmune bullous disease affecting the skin and mucous membranes. Osteoporosis, a significant side effect of commonly used glucocorticoids in treatment, can adversely contribute to the existing morbidity. Objectives: This study aimed to assess the impact of glucocorticoid therapy on bone mineral density in patients with PV. Methods: Patients newly diagnosed with PV were included in this study. Femur and lumbar T-scores, serum calcium, vitamin D, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels were analyzed before and one year after therapy. Results: Among 66 patients, the average time to diagnosis was 10.14 months, and the average daily dose of prednisone was 16.95 mg, with 63.6% of patients receiving medium doses. Our data showed no significant change in lumbar T-scores after one year of glucocorticoid treatment, but a significant decrease in femur density was observed. The decrease in femur T-scores was significant in the medium-dose group, while the lumbar T-scores decreased significantly in the high-dose group. There was no significant correlation between T-scores and sex, menopausal state, diagnosis time, or obesity. Additionally, vitamin D and LDH levels significantly increased after treatment, while changes in serum calcium and ALP levels were not significant. Conclusion: Given the multiple factors that reduce bone mineral density in PV patients, the current strategies for glucocorticoid-induced osteoporosis prophylaxis in this group may need re-evaluation, with potential for additional recommendations to be included in pemphigus guidelines.