Chinese Journal of Dermatology ›› 2022, Vol. 55 ›› Issue (8): 669-675.doi: 10.35541/cjd.20220003

• Original Articles • Previous Articles     Next Articles

Analysis of skin and mucosal infections and their management after primary tumor resection in patients with paraneoplastic pemphigus

Cao Miao1, Chong Shan2, Hu Xinyuan1, Zhu Xuejun1, Wang Mingyue1#br#   

  1. 1Department of Dermatology and Venereology/Nursing Department, Peking University First Hospital, National Clinical Research Center for Skin and Immune Diseases, Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, NMPA Key Laboratory for Quality Control and Evaluation of Cosmetics, Beijing 100034, China; 2Peking University Health Science Center, Beijing 100191, China
    Cao Miao and Chong Shan contributed equally to the article
  • Received:2022-01-04 Revised:2022-04-28 Online:2022-08-15 Published:2022-08-02
  • Contact: Wang Mingyue
  • Supported by:
    National Natural Science Foundation of China (81130030, 81000694); Beijing Municipal Natural Science Foundation (7172214)

Abstract: 【Abstract】 Objective To analyze the occurrence of and risk factors for skin and mucosal infections after primary tumor resection in patients with paraneoplastic pemphigus, and to summarize relevant nursing experience. Methods Clinical characteristics and postoperative skin and mucosal infections were retrospectively analyzed in patients with confirmed paraneoplastic pemphigus, who underwent primary tumor resection in Department of Dermatology, Peking University First Hospital between January 1999 and January 2021. Common infectious agents were analyzed, and infection-related risk factors were identified by logistic regression analysis. Results A total of 44 patients with paraneoplastic pemphigus were included in this study, including 25 (56.8%) males and 19 (43.2%) females, and their age were 33.8 ± 15.4 years. Postoperatively, 21 (47.73%) patients developed skin and mucosal infections, and their postoperative hospital stay (median [Q1, Q3]) was 38 (25, 60) days, which was significantly longer than that in patients without skin and mucosal infections (21 [12, 23] days, Z = -4.08, P < 0.001). The most common pathogen was methicillin-resistant Staphylococcus aureus (15 cases, 34.09%). High glucocorticoid dosage per kilogram of body weight (OR = 1.21, 95% CI: 1.00 - 1.46, P = 0.047) and receiving assisted ventilation therapy (OR = 9.20, 95% CI: 2.01 - 42.13, P = 0.004) were independent risk factors for postoperative skin and mucosal infections. After active treatment and care, 37 (84.1%) patients recovered well at discharge. Conclusion Skin and mucosal infections are a common postoperative complication in patients with paraneoplastic pemphigus, and the pathogens are mostly drug-resistant bacteria, which can lead to prolonged hospital stay, so attention should be paid to postoperative skin care; high postoperative glucocorticoid dosage per body weight and respiratory support may be associated with postoperative skin and mucosal infections.

Key words: Pemphigus, Therapy, Surgical procedures, operative, Infection, Perioperative nursing, Risk factors, Paraneoplastic pemphigus, Skin and mucosal infections