Selim et al. (1995) reported one Egyptian female with pemphigus [See also: Kuwait > Selim et al., 1995].

[Selim MM, Al-Fouzan A, Alsaleh Q, Dvorak R, Hegi V. Pemphigus: A study of 35 cases in Kuwait and review of the literature. Gulf J. Dermatol. 1995; 2(2):17-26.]

Ghaly et al. (2005) studied 17 patients with Pemphigus vulgaris (PS) and 19 control subjects to assess the role of CD44 in controlling mast cell and T-lymphocyte during blister development. CD44 protein expression was determined using immunohistochemistry and flow cytometric studies. Of the patients, 76.5% showed positive expression of the CD44 antigen; PV lesions showing higher positivity compared to the perilesional and normal skin. Ghaly et al. (2005) explained this by indicating presence of a higher amount of proinflammatory cytokines IL-1 alpha and TNF-alpha in the lesions. This increase in CD44 antigens could lead to activation of the T-cells, resulting in the inflammatory process. Patients with PV also showed a higher mean value for the percentages of total lymphocytes expressing CD44 (12%-23%) as compared to the control group (8%-15%). Ghaly et al. (2005) were of the opinion that treatment strategies targeting CD44 would be useful in controlling the inflammatory response in PV. [Ghaly NR, Roshdy OA, Nassar SA, Hamad SM, El-Shafei AM. Role of mast cells and T-lymphocytes in pemphigus vulgaris: significance of CD44 and the c-kit gene product (CD117). East Mediterr Health J. 2005; 11(5-6):1009-17.]

Selim et al. (1995) reported four Iraqi patients with pemphigus (3 females and 1 male) [See also: Kuwait > Selim et al., 1995].

Burgan et al. (1993) presented a rare case of oral pemphigus vulgaris, which developed initially in a 9-year old Jordanian male. The disease was not well controlled with immunosuppressive therapy and was complicated by the development of multiple oral polyps approximately one year after the onset of symptoms. These lesions were smooth, painless and located particularly on the upper labial gingiva, the labial and buccal mucosa and the tongue. Disease activity continued for approximately nine years until the patient was referred to an oral medicine specialist. Histological examination of the polyps revealed exuberant granulation tissue. Adjustment of the steroid dosage lead to resolution of the oral symptoms and the polyps reduced in number and in size.

Selim et al. (1995) reported four Jordanian patients with pemphigus (1 female and 3 males) [See also: Kuwait > Selim et al., 1995].

Selim et al. (1995) reported 35 patients with pemphigus, who attended the Dermatology Department at Al-Sabah Hospital in Kuwait for a period varying from 3 months to 10 years between 1981 and 1990. The population study included 14 Kuwaiti patients (10 females and 4 males), 14 patients (9 females and 5 males) from other Arab nationalities (Jordanian, Iraqi, Syrian, Egyptian, Saudi, and Yemeni), and 7 patients (4 females and 3 males) from non-Arab nationalities. The overall female to male ratio was found to be 1.9:1. This ratio among Kuwaitis was found to be 2.5:1. The age of onset ranged between 14 to 70 years with a mean of 36.8 years among females and 40.4 among males. In this population study, the types of pemphigus were found in the following order in term of frequency: pemphigus vulgaris was 74.2% (12 males and 14 females), pemphigus foliaceous was 14.3% (5 females), and pemphigus erythematosus was 11.4% (4 females). No cases with pemphigus vegetans were observed. The history taken from the patients showed that the onset of the lesions was in the mouth in 40%, skin in 34.4%, and both skin and mucous membranes in 25.7% with an overall mucous membrane affection of 65.7%. Out of the 26 patients with pemphigus vulgaris, 14 (53.8%) showed oral cavity lesions as the first signs to appear. The overall mucous membrane affection of the mouth in the course of pemphigus vulgaris in the population study was found in 22 patients (84.6%). At the time of clinical examination, 60% of the patients had skin and mouth lesions, 14.3% had mouth lesions alone and all were with pemphigus vulgaris and 25.7% had skin lesions alone (5.7% for pemphigus vulgaris, 11.5% for pemphigus foliaceous, and 8.5% for pemphigus erythematosus). Twenty five percent of patients with pemphigus erythematosus and 20% of patients with pemphigus foliaceous were found to have developed mouth lesions in the course of the disease, while none of them had such lesions at the onset of the disease, indicating that the site of initial lesions may influence prognosis of the disease. It was also observed that some cases, where the skin is the only site affected, have highest percentage of clinical remission and lowest percentage of exacerbation, indicating that involvement of oral mucosa may reflect a worse prognosis. All patients complained of itching especially when new lesions are erupting. None of them gave history of exposure to chemicals or drugs. No associated diseases were found in the patients. The pemphigus duration in this population study was less than two years in 28.6%, between two and 10 years in 65.7%, and above 10 years in 5.7%. Twenty five patients were treated with a combination of prednisolone and imuran, nine patients with prednisolone alone, and one with prednisolone plus dapsone. Best results were obtained with combination of prednisolone and imuran. The mortality rate was found to be 8.6% (3 out of 25 patients).

[Selim MM, Al-Fouzan A, Alsaleh Q, Dvorak R, Hegi V. Pemphigus: A study of 35 cases in Kuwait and review of the literature. Gulf J. Dermatol. 1995; 2(2):17-26.]

Alsaleh et al. (1999) conducted a retrospective study to elucidate the clinical features, course, and prognosis of pemphigus in 44 patients who were treated between 1981 and 1996. Around 80% of pemphigus patients were Arabs, and Kuwaitis constituted the largest number (46.3%) with a female predominance (F:M = 2:1). Pemphigus vulgaris (PV) was the commonest clinical type. The mean age of onset was 36 years. The follow-up period ranged from 2 months to 12 years (mean, 4.5 years). The majority of the patients could be managed with low-dose steroids (30-60 mg/day). Twenty per cent of the patients were in complete clinical remission and were off systemic therapy for an average of 3 years. No death secondary to the disease or its treatment was observed.

Zouhair et al. (1999) reported six cases of Herpes simplex infections in patients with pemphigus observed at the Ibn Rochd hospital dermatology unit, Casablanca, over a 3-year period (1995-1998). There were 4 men and 2 women, aged between 27 to 76 years. Superficial pemphigus was observed in 5 cases and pemphigus vulgaris in 1. In all cases, histology showed cytopathogenic Herpes simplex infection. The Herpes simplex infection appeared when the patients were given general corticosteroid therapy.

Selim et al. (1995) reported two Saudi females with pemphigus [See also: Kuwait > Selim et al., 1995].

Selim et al. (1995) reported two Syrian females with pemphigus [See also: Kuwait > Selim et al., 1995].

Selim et al. (1995) reported one Yemeni male with pemphigus [See also: Kuwait > Selim et al., 1995].