title: Malignancies in bullous pemphigoid: A controversial association.
abstract: Bullous pemphigoid (BP) is an autoimmune subepidermal blistering disorder that has been reported to be associated with malignancies. Some authors described several cases of pemphigoid associated with malignancies (PAM); however, the evidence of this correlation still remains controversial. Several theories have been postulated to explain the relationship between malignant neoplasms and BP; the main theory suggests that antibodies directed against tumor-specific antigens of malignant cells may cross-react with antigens (like BP antigens) in the basement membrane zone leading to the formation of blisters. We performed an extensive review of the English published work focusing on the epidemiology, the pathogenetic theories and the clinical and histological aspects of the disease. We identified 40 cases of PAM: of these, seven cases were associated with hematological malignancies and 33 with solid tumors. Physicians should be aware of the existence of PAM and we suggest an oncological screening in early-onset pemphigoid, in patients with a former oncological history, in those with signs and symptoms that could be related to a neoplasm and in BP refractory to common immunosuppressive therapy.
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Balestri
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Magnano
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Michelangelo
authors.initials: M
authors.lastname: La Placa
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Luisa
authors.initials: L
authors.lastname: Angileri
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Vera
authors.initials: V
authors.lastname: Tengattini
authors.affiliation: Division of Dermatology, Department of Specialized, Clinical and Experimental Medicine, University of Bologna, Bologna, Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Bardazzi
mesh_terms: D005260:Female; D019337:Hematologic Neoplasms / Q000150:complications; D006801:Humans; D008297:Male; D008954:Models, Biological; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D010257:Paraneoplastic Syndromes / Q000150:complications; D010391:Pemphigoid, Bullous / Q000150:complications* / Q000276:immunology
keywords: bullous diseases; cancer; malignancy; paraneoplastic; pemphigoid