title: A case of bullous pemphigoid exacerbated by irradiation after breast conservative radiotherapy.
abstract: We present a case, considered to be a form of the Koebner phenomenon, of bullous pemphigoid that was exacerbated mainly within the irradiated field after breast conservative radiotherapy. In May 2009, a 60-year-old woman was diagnosed with bullous pemphigoid, which was treated with steroid therapy. The following month, she was diagnosed with breast cancer (invasive ductal carcinoma, pT1cN0M0). After breast conservative surgery in December 2009, conservative radiotherapy to the right breast was performed (50 Gy in 25 fractions). Portal skin showed no serious change (up to grade 1 skin erythema) and no bullous neogenesis during conservative radiotherapy. However, 2 months after conservative radiotherapy, new blisters became exacerbated mainly within the irradiated field but also in the area outside the irradiated field. Increasing the dosage of oral steroid and minocycline resulted in relief of bullous pemphigoid, although patchy skin pigmentation remained especially in the irradiated skin.
authors.affiliation: Department of Radiation Oncology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan. isohashi@radonc.med.osaka-u.ac.jp
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Isohashi
authors.forename: Koji
authors.initials: K
authors.lastname: Konishi
authors.forename: Noriko
authors.initials: N
authors.lastname: Umegaki
authors.forename: Tomonori
authors.initials: T
authors.lastname: Tanei
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koizumi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
mesh_terms: D000208:Acute Disease; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D018270:Carcinoma, Ductal, Breast / Q000532:radiotherapy / Q000601:surgery; D019583:Dose Fractionation, Radiation; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D015412:Mastectomy, Segmental; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control*; D017698:Postmenopause; D011241:Prednisone / Q000008:administration & dosage*; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects
chemical_list: D005938:Glucocorticoids; D011241:Prednisone