Effects of Micronutrients (Vitamins, Antioxidants, and Other Trace Elements) in Pemphigus Vulgaris: A Systematic Review

Background Pemphigus vulgaris (PV), a chronic and autoimmune disease that affects skin and mucosal membranes, is characterized by the formation of vesicles and blisters. The diagnostic process for PV includes perilesional mucosal or skin biopsies for histopathological analysis and direct immunofluorescence. Micronutrients, such as vitamins, antioxidants, and trace elements, are essential for regeneration against the products of oxidative stress in tissues. Sufficient consumption of micronutrients is necessary for the immune system to operate well. A lack of micronutrients dysregulates the balanced host’s natural defense, which makes people more vulnerable to infections, which raises the risk of morbidity and death. Aim To synthesize evidence on differences in circulating levels of vitamins, antioxidants, and trace elements in patients with PV compared with healthy controls. Methods The researchers searched six electronic databases (PubMed, Medline, Scopus, Science Direct, Cochrane, and Embase) up to April 2024 (without time limitation). Our review included relevant case‐control studies, clinical trials, and prospective cohort studies. A total of 23 studies were analyzed. All measured and compared micronutrient levels in the blood samples of PV patients and the healthy control (HC). Summary Eleven studies assessed vitamins, eleven antioxidants, and eight trace elements. PV patients had significantly lower levels of vitamins and most trace elements but higher levels of antioxidants than HCs. Lead levels were significantly higher in patients with PV. Overall, most studies indicated significantly lower levels of vitamin D, zinc, and selenium in PV patients compared to HCs. Antioxidant findings were mixed, with some markers elevated and others reduced in PV.