Endemic Pemphigus foliaceus ("Fogo selvagem"): a series from the Northeastern region of the State of Säo Paulo, Brazil, 1973-1998

RESUMO

Endemic Pemphigus Foliaceus (EPF) is a bullous autoimmune skin disease whose incidence used to be high in the State of Säo Paulo (SP), Brazil, during the forties, but has declined thereafter. OBJECTIVES: to report a series of EPF patients from the northeastern region of SP. METHODS: a retrospective study concerning demographic and epidemiological data of patients seen from 1973 to 1998 was conducted at the University Hospital, Faculty of Medicine of Ribeiräo Preto, SP. RESULTS: bullous disease was diagnosed in 340 patients, 245 with EPF (72.1 percent), 9.4 cases per year, 60.4 percent females, and 70.2 percent white, 7 to 82 year-old (29.4 percent in their teens); 46.9 percent lived in the rural zone. Concerning profession, housewives predominated among women (67.6 percent) and agricultural workers among men (40.2 percent). The time of disease was less than 1 year in 62.0 percent of cases, followed by 1 and 5 years (27 percent), and more than 5 years for the remaining patients (11 percent). 36.7 percent of patients were referred by the DireçÒo Regional de Saúde (DIR) XVIII of RibeirÒo Preto, with the largest number of cases being from Ribeiräo Preto and Batatais 33.3 percent and 23.3 percent, respectively; 22 percent from DIR XIII (Franca); 13.5 percent from DIR VII (Araraquara); 2.9 percent from DIR IX (Barretos); 4.1 percent from other DIRs of SP, and 20.8 percent from other States (16.7 percent from Minas Gerais). Thirteen (5.3 percent) patients reported occurrence of the disease in some relative, and 4 (1.6 percent) in neighbors. CONCLUSIONS: the present data characterize the northeastern region of the state of SÒo Paulo as a remaining endemic focus of EPF