P-215 Role of Exposure to Environmental and Occupational Factors in the Occurrence of Pemphigus: A Case-Control Study in Tunisia

Introduction The pemphigus is a multifactorial dermatosis. While many etiological hypotheses have been suggested for its occurrence, the exact etiology remains to be determined.Our study aimed to identify the role of environmental and occupational exposure in the induction of pemphigus. Methods We carried out a case-control study on patients with pemphigus. The entire study period lasted six months. Controls were recruited from the general population. The matching of cases and controls was carried out according to gender, age, and professional status. Data collection was based on a pre-established questionnaire. Results A total of 44 cases and 88 controls were collected. Pemphigus erythematosus was the most common (47.7%) followed by pemphigus vulgaris (36.4%). In the binary logistic regression model, smoking, traditional cosmetics, high consumption of spices, pesticide exposure and rural origin were significantly associated with pemphigus. Discussion The pathophysiology of pemphigus is controversial and complex. To explain the dysregulation of the immune system in this pathology, the association of autoimmune, environmental, occupational and genetic factors was retained. Rural origin was incriminated as a risk factor and could be explained by the significant association between rural living conditions, agriculture as the main occupation, and the presence of pathogenic anti-desmoglein 1 autoantibody in rural people, considered as serological abnormalities that may precede the onset of pemphigus. Conclusion Our findings implied that environmental and occupational factors play a key role in the occurrence of pemphigus. Thus, identifying and limiting exposure to these factors is necessary for the prevention of this dermatosis