Increased Risk of Severe Course of Pemphigus in Patients with Pemphigus-Associated Alopecia: A Prospective Observational Study

This prospective observational study included 80 patients with confirmed pemphigus, of whom 11 (13.8%) had pemphigus‐associated alopecia. The study found that patients with pemphigus‐associated alopecia had significantly higher Pemphigus Disease Area Index total activity scores (21.8 ± 18.6) compared to those without alopecia (11.0 ± 20.5; P = 0.02). Additionally, these patients had higher mean serum anti‐desmoglein (Dsg)1 and anti‐Dsg3 antibody concentrations (141.8 ± 66.9 U/mL and 126.6 ± 36.7 U/mL, respectively) compared to those without alopecia (60.0 ± 52.6 U/mL and 67.4 ± 52.5 U/mL, respectively; P = 0.03 for both). The study concluded that pemphigus‐associated alopecia is a marker of severe and treatment-resistant disease.