DOI QR코드

DOI QR Code

Oral Manifestation of Paraneoplastic Pemphigus

  • Kim, Seurin (Department of Orofacial Pain and Oral Medicine, Dental Hospital of Yonsei University College of Dentistry) ;
  • Park, In Hee (Department of Orofacial Pain and Oral Medicine, Dental Hospital of Yonsei University College of Dentistry) ;
  • Park, YounJung (Department of Orofacial Pain and Oral Medicine, Dental Hospital of Yonsei University College of Dentistry) ;
  • Kwon, Jeong-Seung (Department of Orofacial Pain and Oral Medicine, Dental Hospital of Yonsei University College of Dentistry) ;
  • Choi, Jong-hoon (Department of Orofacial Pain and Oral Medicine, Dental Hospital of Yonsei University College of Dentistry) ;
  • Ahn, Hyung-Joon (Department of Orofacial Pain and Oral Medicine, Dental Hospital of Yonsei University College of Dentistry)
  • 투고 : 2019.06.14
  • 심사 : 2019.07.09
  • 발행 : 2019.09.30

초록

Paraneoplastic pemphigus (PNP) is a rare and often fatal autoimmune blistering disease accompanied by both benign and malignant neoplasms. Usually, oral, skin, and mucosal lesions are the earliest manifestations shown by PNP patients. Oral ulcers are initial lesions in various autoimmune diseases like pemphigus, bullous pemphigoid, erythema multiforme, graft-versus-host, lichen planus, it does not improved despite of high-dose steroid therapy. We report a-35-year-old female who presented oral ulceration, lip crust and skin lesions. By doing several examinations, such as enzyme-linked immunosorbent assay, incisional biopsy with indirect immunofluorescence, she was diagnosed PNP with non-Hodgkin's lymphoma on pancreas.

키워드

참고문헌

  1. Zimmermann J, Bahmer F, Rose C, Zillikens D, Schmidt E. Clinical and immunopathological spectrum of paraneoplastic pemphigus. J Dtsch Dermatol Ges 2010;8:598-606.
  2. Anhalt GJ, Kim SC, Stanley JR, et al. Paraneoplastic pemphigus. An autoimmune mucocutaneous disease associated with neoplasia. N Engl J Med 1990;323:1729-1735. https://doi.org/10.1056/NEJM199012203232503
  3. Vassileva S, Drenovska K, Manuelyan K. Autoimmune blistering dermatoses as systemic diseases. Clin Dermatol 2014;32:364-375. https://doi.org/10.1016/j.clindermatol.2013.11.003
  4. Mimouni D, Anhalt GJ, Lazarova Z, et al. Paraneoplastic pemphigus in children and adolescents. Br J Dermatol 2002;147:725-732. https://doi.org/10.1046/j.1365-2133.2002.04992.x
  5. Porro AM, Caetano Lde V, Maehara Lde S, Enokihara MM. Nonclassical forms of pemphigus: pemphigus herpetiformis, IgA pemphigus, paraneoplastic pemphigus and IgG/IgA pemphigus. An Bras Dermatol 2014;89:96-106. https://doi.org/10.1590/abd1806-4841.20142459
  6. Helm TN, Camisa C, Valenzuela R, Allen CM. Paraneoplastic pemphigus. A distinct autoimmune vesiculobullous disorder associated with neoplasia. Oral Surg Oral Med Oral Pathol 1993;75:209-213. https://doi.org/10.1016/0030-4220(93)90095-L
  7. Choi Y, Nam KH, Lee JB, et al. Retrospective analysis of 12 Korean patients with paraneoplastic pemphigus. J Dermatol 2012;39:973-981. https://doi.org/10.1111/j.1346-8138.2012.01655.x
  8. Yong AA, Tey HL. Paraneoplastic pemphigus. Australas J Dermatol 2013;54:241-250. https://doi.org/10.1111/j.1440-0960.2012.00921.x
  9. Gergely L, Varoczy L, Vadasz G, Remenyik E, Illes A. Successful treatment of B cell chronic lymphocytic leukemia-associated severe paraneoplastic pemphigus with cyclosporin A. Acta Haematol 2003;109:202-205. https://doi.org/10.1159/000070972
  10. Paolino G, Didona D, Magliulo G, et al. Paraneoplastic pemphigus: insight into the autoimmune pathogenesis, clinical features and therapy. Int J Mol Sci 2017;18:E2532. https://doi.org/10.3390/ijms18122532
  11. Kelly S, Schifter M, Fulcher DA, Lin MW. Paraneoplastic pemphigus: two cases of intra-abdominal malignancy presenting solely as treatment refractory oral ulceration. J Dermatol 2015;42:300-304. https://doi.org/10.1111/1346-8138.12753
  12. Zhu X, Zhang B. Paraneoplastic pemphigus. J Dermatol 2007;34:503-511. https://doi.org/10.1111/j.1346-8138.2007.00322.x
  13. Frew JW, Murrell DF. Paraneoplastic pemphigus (paraneoplastic autoimmune multiorgan syndrome): clinical presentations and pathogenesis. Dermatol Clin 2011;29:419-425, viii. https://doi.org/10.1016/j.det.2011.03.018
  14. Kartan S, Shi VY, Clark AK, Chan LS. Paraneoplastic pemphigus and autoimmune blistering diseases associated with neoplasm: characteristics, diagnosis, associated neoplasms, proposed pathogenesis, treatment. Am J Clin Dermatol 2017;18:105-126. https://doi.org/10.1007/s40257-016-0235-z
  15. Hertl M, Eming R, Veldman C. T cell control in autoimmune bullous skin disorders. J Clin Invest 2006;116:1159-1166. https://doi.org/10.1172/JCI28547
  16. Bialy-Golan A, Brenner S, Anhalt GJ. Paraneoplastic pemphigus: oral involvement as the sole manifestation. Acta Derm Venereol 1996;76:253-254.
  17. Ishii N, Maeyama Y, Karashima T, et al. Immunoserological analyses of 55 patients with pemphigus at the Dermatological Department of Kurume University Hospital: an 11-year retrospective study (1996-2006). Int J Dermatol 2008;47:1321-1322. https://doi.org/10.1111/j.1365-4632.2008.03712.x
  18. Helou J, Allbritton J, Anhalt GJ. Accuracy of indirect immunofluorescence testing in the diagnosis of paraneoplastic pemphigus. J Am Acad Dermatol 1995;32:441-447. https://doi.org/10.1016/0190-9622(95)90066-7
  19. Lee SE, Hashimoto T, Kim SC. No mucosal involvement in a patient with paraneoplastic pemphigus associated with thymoma and myasthenia gravis. Br J Dermatol 2008;159:986-988. https://doi.org/10.1111/j.1365-2133.2008.08763.x