Association of pemphigus and pemphigoid with osteoporosis and pathological fractures

Raj Chovatiya*, Jonathan I. Silverberg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Patients with pemphigus and bullous pemphigoid (BP) have potential risk factors for osteoporosis and/or fractures. To determine whether pemphigus and BP are associated with osteoporosis and fractures in the US, a cross-sectional study of 198,102,435 adults was performed, including 4506 with pemphigus and 8864 with BP from the 2006–2012 National Emergency Department Sample, a 20% sample of emergency care visits throughout the US. Pemphigus was associated with higher odds (multivariate logistic regression; adjusted odds ratio [95% confidence intervals]) of osteopenia (2.20 [1.59–3.05]), osteoporosis (2.54 [2.16–2.98]), osteomalacia (29.70 [4.05–217.83]), and pathological fractures (2.04 [1.42–2.91]). BP was associated with osteoporosis (1.55 [1.39–1.73]) and pathological fractures (1.52 [1.22–1.88]). When compared to BP, pemphigus was associated with higher odds of osteopenia (1.59 [1.06–2.41]), osteoporosis (1.38 [1.18–1.63]), and fractures (1.26 [1.04–1.53]), particularly of the ulna and radius (3.17 [1.23–8.17]). Patients with pemphigus or BP as well as long-term systemic corticosteroid use had highest odds of osteoporosis and fractures. No data were available on treatments for pemphigus or BP. Pemphigus and BP were associated with osteopenia, osteoporosis, and pathologic fractures. Patients with PEM and BP may benefit from increased screening for osteoporosis and interventions to prevent fractures.

Original languageEnglish (US)
Pages (from-to)263-271
Number of pages9
JournalArchives of Dermatological Research
Issue number4
StatePublished - May 1 2020


  • Autoimmune
  • Bullous
  • Burden
  • Comorbidities
  • Cost of care
  • Emergency care
  • Hospitalization
  • Length of stay
  • Osteomalacia
  • Osteopenia
  • Osteoporosis
  • Pemphigoid
  • Pemphigus
  • Urgent care

ASJC Scopus subject areas

  • Dermatology


Dive into the research topics of 'Association of pemphigus and pemphigoid with osteoporosis and pathological fractures'. Together they form a unique fingerprint.

Cite this