Analysis of skin and mucosal infections and their management after primary tumor resection in patients with paraneoplastic pemphigus / 中华皮肤科杂志

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.