title: Cicatricial pemphigoid of the oropharynx after allogeneic stem cell transplantation for relapsed follicular lymphoma.
abstract: A 44-year-old woman with refractory follicular lymphoma underwent allogeneic stem cell transplantation (SCT) and achieved complete remission. Grade III acute graft-versus-host disease (GVHD) developed on day 23, but no chronic GVHD occurred. The patient developed severe erosion with bullous lesions in the oral cavity 18 months after SCT. At that time, the lymphoma remained in complete remission, and she had no clinical or laboratory findings suggesting chronic GVHD. A biopsy of the oral mucosa showed moderate lymphoplasmacytic infiltration and subepidermal bullae, and direct immunofluorescence staining demonstrated linear deposition of C3 at the dermo-epidermal junction. An immunoblotting assay using human epidermal extracts confirmed the presence in her serum of an antibody against the 230-kd bullous pemphigoid antigen 1 (BPAG1). A diagnosis of cicatricial pemphigoid (CP) was made, and complete resolution of the CP was achieved with prednisolone therapy. The occurrence of autoimmune blistering diseases is rare after allogeneic SCT.
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan. yaisa@sc.itc.keio.ac.jp
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Aisa
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Tomonori
authors.initials: T
authors.lastname: Nakazato
authors.forename: Rie
authors.initials: R
authors.lastname: Yamazaki
authors.forename: Jun
authors.initials: J
authors.lastname: Yamagami
authors.forename: Masayuki
authors.initials: M
authors.lastname: Amagai
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ikeda
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008224:Lymphoma, Follicular / Q000150:complications / Q000473:pathology* / Q000628:therapy; D009055:Mouth / Q000473:pathology*; D009960:Oropharynx / Q000473:pathology*; D010390:Pemphigoid, Benign Mucous Membrane / Q000188:drug therapy / Q000209:etiology / Q000473:pathology*; D011239:Prednisolone / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D011239:Prednisolone