Sulfhydryl-Containing Foods and Drugs Linked to Pemphigus Vulgaris Risk: Study

The study, published in Postepy Dermatologii i Alergologii (Advances in Dermatology and Allergology), was conducted by Dr. Goknur Ozaydın Yavuz and colleagues from the Department of Dermatology, Health Sciences University, Istanbul, Turkey. It explored the potential link between serum total sulfhydryl (TSH) levels and the autoimmune skin condition pemphigus vulgaris (PV). 

Pemphigus vulgaris is a rare and potentially life-threatening autoimmune blistering disease characterized by the production of autoantibodies against desmoglein-1 and desmoglein-3, which are essential components in maintaining skin cell adhesion. The disruption of these proteins leads to acantholysis—the loss of cell-to-cell adhesion in the skin—and the formation of painful blisters and erosions.

Sulfhydryl groups, also known as thiol groups, play a crucial role in maintaining cellular function. They are involved in antioxidant defense, detoxification, cellular proliferation, and programmed cell death. Previous research has suggested that chemical exposure, including that containing sulfhydryl compounds, may contribute to acantholysis and subsequent skin damage.

To investigate this further, the research team conducted a case-control study involving 177 participants, including 86 patients diagnosed with pemphigus vulgaris and 91 healthy individuals as controls. Detailed demographic and lifestyle data—including age, gender, smoking and alcohol habits, and dietary intake of foods known to trigger pemphigus—were recorded for each participant.

The diagnosis of PV was established through clinical evaluation, histopathological findings, and confirmation via direct and indirect immunofluorescence tests. Blood samples were collected, and serum total sulfhydryl levels were measured using a spectrophotometric method.

The findings revealed the following:

• The average age of patients in the pemphigus vulgaris (PV) group was 41.94 years.
• The average age in the control group was 39.86 years.
• Smoking was in 62.8% of the PV patients.
• Alcohol consumption was observed in 32.6% of the PV patients.
• There was a statistically significant difference in serum total sulfhydryl levels between the PV and the control group.

Based on these results, the authors concluded that compounds containing sulfhydryl groups—commonly found in certain medications and foods—may play a role in triggering or exacerbating pemphigus vulgaris. The exact mechanisms remain to be fully understood, but the study emphasizes the potential importance of monitoring sulfhydryl exposure in individuals diagnosed with PV or at risk for the disease.

The research adds to growing evidence that environmental and dietary factors may influence the course of autoimmune skin diseases. Further studies are needed to clarify the causal relationships and to establish dietary guidelines that may help in managing or preventing PV flare-ups.

Reference:

Ozaydın Yavuz, Goknur, et al. “Evaluation of Total Sulfhydryl Levels and Dietary Habits in Pemphigus Vulgaris.” Postepy Dermatologii I Alergologii, vol. 42, no. 3, 2025, pp. 255-258.