Paraneoplastic pemphigoid-pemphigus? Subepidermal bullous disease with pemphigus-like direct immunofluorescence.
BACKGROUND
Paraneoplastic pemphigus is a recently described variant of pemphigus, in which classic immunologic features of pemphigus are associated with subepidermal erythema multiforme-like bullae.


METHODS
Two patients with underlying malignant neoplasm had a bullous disease, which had clinical and histologic features suggestive of bullous pemphigoid while direct immunofluorescence revealed intercellular deposits of IgG and C3 throughout the malpighian layer of epidermis, a pattern usually diagnostic for pemphigus. Indirect immunofluorescence studies were negative. One mg/kg/day prednisone was enough to cure the eruption in a couple of weeks without any recurrence.


CONCLUSIONS
The disease differs from the recently reported paraneoplastic pemphigus and from other bullous diseases associating circulating pemphigus-like antibodies with clinical, histologic, and often even immunologic features of bullous pemphigoid.
Rongioletti
F
F
Department of Dermatology, University of Genoa, Italy.
Truchetet
F
F
Rebora
A
A
D000368:Aged; D003176:Complement C3 / Q000032:analysis; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010257:Paraneoplastic Syndromes / Q000378:metabolism / Q000473:pathology*; D010391:Pemphigoid, Bullous / Q000378:metabolism / Q000473:pathology*; D010392:Pemphigus / Q000378:metabolism / Q000473:pathology*
D003176:Complement C3; D007074:Immunoglobulin G