There has not been publication of any previous study about the role of secretory status or Lewis phenotypes in the mechanisms of pemphigus vulgaris (PV).To evaluate the frequencies of secretory status and Lewis phenotypes in patients with PV compared with healthy controls (HCs) in order determine their roles in this autoimmune disease.In total, 50 patients and 100 age- and sex-matched HCs were selected to form the study population, and 2 mL blood were collected from each subject to identify their Lewis phenotype. In subjects with the Le(a-b-) phenotype, saliva was also collected to determine secretor status.The frequency of the nonsecretor (NS) phenotypes Le(a+b-) and Le(a-b-) together was significantly higher in patients than in HCs: 34/50 (68%)vs. 26/100 (26%), respectively (P < 0.001). All the patients and HC subjects with the Le (a-b-) phenotype were found to be NS by haemagglutination inhibition assay of saliva samples.Based on our results, it seems that Le/b-negative NS individuals are more susceptible to PV.