Abstract: 【Abstract】 Objective To summarize the clinical and related characteristics of hospitalized patients with pemphigus, and to analyze their correlations with systemic inflammatory and serological indicators. Methods A retrospective analysis was conducted on the clinical data from pemphigus patients hospitalized in the Department of Dermatology, Wuhan No.1 Hospital from January 2021 to December 2023. Spearman correlation analysis was performed to assess the correlations between the Pemphigus Disease Area Index （PDAI） scores and systemic immune-inflammation index （SII）, pan-immune-inflammation value （PIV）, serum albumin levels, anti-desmoglein 1/3 （Dsg-1/3） antibody levels, and C-reactive protein （CRP） levels. Linear regression models were used to evaluate the associations of systemic inflammatory and serological indicators with the length of hospital stay and treatment costs. Logistic regression analysis was conducted to analyze the effect of these indicators on the risk of infection in pemphigus patients. Results A total of 235 pemphigus patients were included （112 males and 123 females）, with ages of 58.12 ± 16.47 years. Among them, 73 patients （31.06%） had pemphigus alone, while 162 （68.94%） had comorbidities including tumors, infections, or hypoalbuminemia. PDAI scores showed significantly positive correlations with SII, PIV, and CRP levels （r = 0.62, 0.58, 0.50, respectively, all P＜0.001）. According to PDAI scores, 164 cases （69.79%） were classified as mild pemphigus, 57 （24.26%） as moderate pemphigus, and 14 （5.96%） as severe pemphigus; compared with the patients with mild pemphigus, those with moderate-to-severe pemphigus had significantly increased SII, PIV, anti-Dsg-1 antibody and CRP levels, but significantly decreased serum albumin levels （all P < 0.05）. Among the 235 patients, 213 were diagnosed with pemphigus vulgaris, 9 with pemphigus erythematosus, 10 with pemphigus foliaceus, and 3 with paraneoplastic pemphigus; serum albumin levels and anti-Dsg-1/3 antibody levels differed significantly among patients with different subtypes of pemphigus （all P < 0.05）. The serum albumin level was significantly associated with the length of hospital stay and treatment costs （β ［95% CI］: -0.729 ［-0.946 - -0.512］, -0.266 ［-0.362 - -0.171］, respectively, both P < 0.001）; furthermore, the serum albumin level was identified as a relevant factor for infections in pemphigus patients （OR = 0.938, 95% CI: 0.883 - 0.995, P = 0.036）. Conclusion SII, PIV, CRP, serum albumin, and anti-Dsg-1 antibody levels could reflect the severity of pemphigus to some extent, and the serum albumin level was significantly associated with comorbid infections, length of hospital stay, and treatment costs in hospitalized patients with pemphigus.

Key words: Pemphigus, Pemphigus disease area index, Systemic immune-inflammatory index, Pan-immune-inflammation value, C-reactive protein, Anti-Dsg-1/3 antibody