A case of bullous disease limited to the skin illustrates the spectrum of neoplasia-induced autoimmunity.
Although the initial report of paraneoplastic pemphigus described individuals with mucocutaneous blistering disease, subsequent reports identified patients with lichen planus or graft versus host disease-like changes. We describe a patient with fatal autoimmune blistering disease with absence of mucous membrane lesions. The pattern of complement indirect immunofluoresence helped identify the prognosis prospectively. This case illustrates yet another presentation of the neoplasia-induced autoimmunity.
Grover
Raminder K
RK
Beutner Laboratories and the Departments of Microbiology and Immunology and Dermatology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, New York, USA. rgrover2@buffalo.edu
Stites
P Craig
PC
Helm
Thomas N
TN
Hashimoto
Takashi
T
Beutner
Ernst H
EH
D000369:Aged, 80 and over; D000974:Antibodies, Antinuclear / Q000276:immunology; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D058846:Antibodies, Monoclonal, Murine-Derived; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D003168:Complement Fixation Tests; D003520:Cyclophosphamide / Q000008:administration & dosage; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D010257:Paraneoplastic Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D010392:Pemphigus / Q000175:diagnosis; D011241:Prednisone / Q000008:administration & dosage; D000069283:Rituximab; D018805:Sepsis / Q000150:complications; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D014750:Vincristine / Q000008:administration & dosage
D000974:Antibodies, Antinuclear; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D014750:Vincristine; D003520:Cyclophosphamide; D011241:Prednisone