Investigating Atherosclerosis through Ultrasonographic Assessment of Carotid Intima-Media Thickness in Pemphigus Vulgaris: A Case-Control Study

INTRODUCTION: Pemphigus vulgaris (PV) is an autoimmune blistering dermatosis affecting both sexes. Previous studies suggest an increased cardiovascular risk in PV patients, though the underlying mechanisms remain unclear. METHODS: This case-control study evaluated carotid intima-media thickness (CIMT) via ultrasonography as a marker of subclinical atherosclerosis in PV. Seventy patients were categorized based on disease duration (<1 year and 1-4 years) and compared to 35 age- and gender-matched healthy controls. Data on demographics, Pemphigus Disease Area Index (PDAI), and total rituximab (RTX) dosage were collected. RESULTS: Age was significantly correlated with CIMT in all groups. Although left and right plaque presence was significant in controls (p = 0.007), no significant plaque burden was observed in either patient group. CIMT showed a significant positive correlation with waist circumference in the <1-year group and controls (p = 0.027 and p = 0.001, respectively) and with BMI in the <1-year group. PDAI was significantly associated only with left CIMT in patients with 1-4 years of disease (p = 0.035). Additionally, male patients in the 1-4-year group had significantly higher left and right CIMT (p = 0.014 and p = 0.047, respectively). No significant differences in CIMT size or plaque presence were observed between patient and control groups. CONCLUSION: These findings suggest that age, gender, BMI, waist circumference, and disease severity may contribute to subclinical atherosclerosis in PV, with plaque formation potentially linked to persistent inflammation.