Spatial Distribution of Pemphigus Occurrence over Five Decades in Southeastern Brazil

Author(s)

Celere, Beatriz Smidt ^{[1, 2]} ; Vernal, Sebastian ^{[3, 4]} ; La Serra, Leonardo ^{[3, 4]} ; Franco Brochado, Maria Jose ^{[3, 4]} ; Moschini, Luiz Eduardo ^{[5, 6]} ; Roselino, Ana Maria ^{[3, 4]} ; Segura-Munoz, Susana Ines ^{[1, 2]}

Affiliation

^[1] Univ Sao Paulo, Dept Maternal Infant Nursing & Publ Hlth, Sao Paulo - Brazil

^[2] Univ Sao Paulo, Dept Maternal Infant Nursing & Publ Hlth, Ribeirao Preto - Brazil

^[3] Univ Sao Paulo, Ribeirao Preto Med Sch, Div Dermatol, Dept Clin Med, Sao Paulo - Brazil

^[4] Univ Sao Paulo, Ribeirao Preto Med Sch, Dept Clin Med, Div Dermatol, Ribeirao Preto - Brazil

^[5] Univ Fed Sao Carlos, Dept Environm Sci, Ctr Biol & Hlth Sci, Sao Paulo - Brazil

^[6] Univ Fed Sao Carlos, Ctr Biol & Hlth Sci, Dept Environm Sci, Sao Carlos, SP - Brazil

• Document type: Journal article
• Source: American Journal of Tropical Medicine and Hygiene; v. 97, n. 6, p. 1737-1745, 2017.
• Web of Science Citations: 0

Abstract

Well-defined locations of pemphigus cases support the hypothesis of environmental factors' involvement in its etiopathogenesis; however, these foci have never been described using specialized geographical tools. This is the first report to geo-reference pemphigus cases in a high-prevalence Brazilian region using geographic information systems. We aimed to report the spatio-temporal behavior of pemphigus foliaceus (PF) and vulgaris (PV) in southeastern Brazil, over the last five decades to describe geographical clusters, as well as to characterize the land use in the city with the highest number of cases. Patients were identified from 1965 to 2014. Maps were developed using ArcGIS software and organized into decades from 1965 to 2014. Ribeirao Preto was identified as the city with the greatest number of cases. Land use was analyzed within a 2 km-buffer surrounding the residence of each patient. A total of 426 cases of pemphigus were identified. PF was the predominant form (285 cases); notwithstanding, the number of new cases of PV rose, overtaking the number of new cases of PF in the last decade studied. Agricultural area (42%) and exposed soil (33.2%) are the most predominant land uses in Ribeirao Preto surrounding patients' residences. This study shows high-confidence geographical foci of PF and PV, as well as provides evidence of an increase of both clinical forms over the last five decades. All cases of PV and PF are in proximity to rivers and agricultural areas which reinforce the hypothesis that environmental factors play a role in pemphigus etiopathogenesis. (AU)

• FAPESP's process: 14/10038-8 - Spatial analysis of pemphigus vulgaris and pemphigus foliaceus distribution within the scope of three watersheds located in the Northeast region of São Paulo State and its relation with environmental factors
• Grantee: Beatriz Smidt Celere
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 10/51729-2 - Relation between immunogenetics and environmental factors in a Brazilian epidemiological study of Pemphigus vulgaris and Pemphigus foliaceus
• Grantee: Ana Maria Ferreira Roselino
• Support Opportunities: Research Projects - Thematic Grants