1
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Matsuo M, Niwa H, Koga H, Ishii N, Nakamura N, Iwata H. A case of paraneoplastic pemphigus associated with follicular lymphoma positive only for anti-desmoglein 3 antibody. J Dermatol 2024; 51:e164-e165. [PMID: 38111329 DOI: 10.1111/1346-8138.17059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/18/2023] [Accepted: 11/11/2023] [Indexed: 12/20/2023]
Affiliation(s)
- Maho Matsuo
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hirofumi Niwa
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroshi Koga
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Norito Ishii
- Department of Dermatology, Kurume University School of Medicine, Fukuoka, Japan
| | - Nobuhiko Nakamura
- Department of Hematology and Infectious Disease, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroaki Iwata
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
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2
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Murrell DF, Daneshpazhooh M. Impairment of sexual function in patients with pemphigus. J Eur Acad Dermatol Venereol 2024; 38:643-644. [PMID: 38523507 DOI: 10.1111/jdv.19882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Dedee F Murrell
- Department of Dermatology, St George Hospital, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
| | - Maryam Daneshpazhooh
- Autoimmune Bullous Diseases Research Center, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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3
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Norikawa N, Yamamoto T. Raccoon eyes sign in pemphigus foliaceus. Int J Dermatol 2024; 63:117-118. [PMID: 37807455 DOI: 10.1111/ijd.16832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/26/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Natsumi Norikawa
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
| | - Toshiyuki Yamamoto
- Department of Dermatology, Fukushima Medical University, Fukushima, Japan
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4
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Feng J, Liu Y, Ren Y, Shi W, Kang H, Tan Y, Wu R, Zhang G, He Y. Evaluation of Dry Eye Severity and Ocular Surface Inflammation in Patients with Pemphigus and Pemphigoid. Ocul Immunol Inflamm 2024; 32:62-70. [PMID: 36637982 DOI: 10.1080/09273948.2022.2154680] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/29/2022] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate ocular surface involvement, tear cytokine levels, and histopathological changes in pemphigus and pemphigoid patients. METHODS A total of 22 patients (15 pemphigus and 7 pemphigoids) and 21 non-diseased controls were enrolled in our study. All participants underwent ocular surface evaluation, which included ocular surface disease index test, slit lamp observation, dry eye-related examination, tear multicytokine analysis, and conjunctival impression cytology. RESULTS Pemphigus and pemphigoid patients presented much more severe conjunctivochalasis, corneal epithelial defects, corneal opacity, symblepharon and dry eye. Severe ocular surface squamous metaplasia and a significant increase of tear macrophage inflammatory protein-1beta, tumor necrosis factor-alpha, interleukin (IL)-1β, IL -6, and IL-8 occurred in pemphigus and pemphigoid patients. CONCLUSIONS Our results revealed that ocular surface inflammation and dry eye persist in most pemphigus and pemphigoid patients, and do not occur in parallel with the systemic course. Regular ophthalmological examinations and local anti-inflammatory should be provided for pemphigus and pemphigoid patients.
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Affiliation(s)
- Jianing Feng
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
- Xi'an People's Hospital (Xi'an Fourth Hospital), Shaanxi Eye Hospital, Northwest University Affiliated People's Hospital, Xi'an, Shaanxi Province, China
| | - Yingyi Liu
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Yuerong Ren
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Wen Shi
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Huanmin Kang
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
| | - Yixin Tan
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ruifang Wu
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guiying Zhang
- Department of Dermatology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan He
- Department of Ophthalmology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Ophthalmology, Hunan Clinical Research Center of Ophthalmic Disease, Changsha, Hunan, China
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5
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Huang J, Shi W. Dirt-Like Lesions With Pemphigus Foliaceus. J Cutan Med Surg 2024; 28:103. [PMID: 38205798 DOI: 10.1177/12034754231224369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Affiliation(s)
- Jundong Huang
- Hu Nan Key Laboratory of Aging Biology, Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
| | - Wei Shi
- Hu Nan Key Laboratory of Aging Biology, Department of Dermatology, Xiangya Hospital, Central South University, Changsha, China
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6
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Kaur M, Hedge N, Agarwal A, Vishwajeet V, Patra S, Singh S. Hematemesis in pemphigus vulgaris: A challenging case of isolated esophageal flare in patient in remission. J Dtsch Dermatol Ges 2023; 21:1551-1553. [PMID: 37811762 DOI: 10.1111/ddg.15196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Accepted: 06/26/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Maninder Kaur
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Nagbhushan Hedge
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Ashish Agarwal
- Department of Gastroenterology, All India Institute of Medical Sciences, Jodhpur, India
| | - Vikarn Vishwajeet
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Suman Patra
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
| | - Saurabh Singh
- Department of Dermatology, Venereology and Leprology, All India Institute of Medical Sciences, Jodhpur, India
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7
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Balighi K, Aryanian Z, Balighi S, Etesami I, Hatami P. A case report of esophageal cancer in a patient with pemphigus vulgaris: A coincidence or something beyond that? Cancer Rep (Hoboken) 2023; 6:e1896. [PMID: 37706662 PMCID: PMC10728544 DOI: 10.1002/cnr2.1896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 08/09/2023] [Accepted: 08/27/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Pemphigus is a group of rare but serious autoimmune blistering disorders, affecting skin and mucus membrane. Different reports have been published in respect to the coexistence of pemphigus with neoplasms, especially lympho-proliferative ones. CASE Here, we have reported a patient previously diagnosed with pemphigus vulgaris (PV) who developed esophageal squamous cell carcinoma (SCC). CONCLUSION Dyspepsia and dysphagia in patients with PV might not be merely due to pemphigus erosions or simply an adverse effect of systemic corticosteroid such as irritant or candidal esophagitis and should raise the suspicion of more serious conditions in case of resistant symptoms without appropriate response to treatment.
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Affiliation(s)
- Kamran Balighi
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Zeinab Aryanian
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
- Department of DermatologyBabol University of Medical SciencesBabolIran
| | - Shadi Balighi
- Department of DermatologyBabol University of Medical SciencesBabolIran
- School of Allied Medical SciencesTehran University of Medical SciencesTehranIran
| | - Ifa Etesami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
- Department of Dermatology, School of Medicine Razi HospitalTehran University of Medical SciencesTehranIran
| | - Parvaneh Hatami
- Autoimmune Bullous Diseases Research CenterTehran University of Medical SciencesTehranIran
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8
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Petti S, Arduino PG. New-onset pemphigus vulgaris and pemphigus foliaceus following COVID-19 infection and vaccination, systematic review of case reports and a causal hypothesis. J Eur Acad Dermatol Venereol 2023; 37:e1256-e1260. [PMID: 37328927 DOI: 10.1111/jdv.19271] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 06/18/2023]
Affiliation(s)
- S Petti
- Department of Public Health and Infectious Diseases, Sapienza University, Rome, Italy
| | - P G Arduino
- Department of Surgical Sciences, University of Turin, Turin, Italy
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9
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Moe KK, Wang CC. Pemphigus vegetans overlying an occlusive hemodialysis fistula and involving multiple digits. J Dermatol 2023; 50:e333-e334. [PMID: 37208819 DOI: 10.1111/1346-8138.16834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/30/2023] [Accepted: 05/02/2023] [Indexed: 05/21/2023]
Affiliation(s)
- Kyu-Kyu Moe
- Department of Pathology, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Chia-Chen Wang
- Department of Dermatology, Cardinal Tien Hospital, New Taipei City, Taiwan
- School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
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10
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Alsaedi OK, Alqahtani MM, Al-Mubarak LA. Wound myiasis by housefly in a patient with pemphigus vulgaris in Riyadh, Saudi Arabia. Saudi Med J 2023; 44:940-943. [PMID: 37717963 PMCID: PMC10505294 DOI: 10.15537/smj.2023.44.9.20220938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 08/02/2023] [Indexed: 09/19/2023] Open
Abstract
Myiasis is the infestation of live vertebrates by dipterous larvae. Cutaneous myiasis is the most common form, although many organs can be infected by these larvae. Cutaneous myiasis is divided into 3 forms: localized furuncular, migratory, and wound myiasis, which have a worldwide distribution, but tropical and subtropical countries have a heavier burden of the disease. Herein, we report a case of scalp wound myiasis in a patient with pemphigus vulgaris caused by Muscidae domestica (M. domestica) in Riyadh, Saudi Arabia. Cases of M. domestica myiasis are limited in the literature. We would like to raise awareness regarding the possibility of cutaneous myiasis in M. domestica in Riyadh, Saudi Arabia.
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Affiliation(s)
- Ohoud Khalid Alsaedi
- From the Department of Dermatology and Dermatology Surgery (Alsaedi, Al-Mubarak), and from the Department of Otolaryngology and Head and neck Surgery (Alqahtani), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Munahi Mohammed Alqahtani
- From the Department of Dermatology and Dermatology Surgery (Alsaedi, Al-Mubarak), and from the Department of Otolaryngology and Head and neck Surgery (Alqahtani), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Luluah Ali Al-Mubarak
- From the Department of Dermatology and Dermatology Surgery (Alsaedi, Al-Mubarak), and from the Department of Otolaryngology and Head and neck Surgery (Alqahtani), Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
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11
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Akham R, Bhatia R, Paonam R, Hazarika N. Rescue treatment with intravenous immunoglobulin and amniotic membrane dressing in refractory paediatric pemphigus vulgaris with sepsis. BMJ Case Rep 2023; 16:e253507. [PMID: 37558274 PMCID: PMC10414109 DOI: 10.1136/bcr-2022-253507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/11/2023] Open
Abstract
We report a case of refractory paediatric pemphigus vulgaris with sepsis, treated successfully with intravenous immunoglobulin (IVIG) and amniotic membrane dressing. The patient was initially started on oral prednisolone (1 mg/kg/day) and dapsone 50 mg once daily. Azathioprine 50 mg orally was then used in place of dapsone due to rapid disease progression with extensive skin involvement. However, the patient developed sepsis and azathioprine had to be discontinued. Because of rapidly progressive disease and sepsis, the patient was put on IVIG at a dose of 2 g/kg in divided doses over 3 days along with amniotic membrane dressing. There was marked improvement after 2 weeks of follow-up.
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Affiliation(s)
- Rojita Akham
- Dermatology, Venereology & Leprosy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Riti Bhatia
- Dermatology, Venereology & Leprosy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rikita Paonam
- Dermatology, Venereology & Leprosy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Neirita Hazarika
- Dermatology, Venereology & Leprosy, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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12
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Hou TH, Fang WC, Cheng YW, Chiu LW, Chen YY. Pemphigus vulgaris complicated with extensive keloid formation and induction of keloid regression during disease recurrence. Eur J Dermatol 2023; 33:444-446. [PMID: 37823505 DOI: 10.1684/ejd.2023.4525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Affiliation(s)
- Ting-Hsuan Hou
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wei-Cheng Fang
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yu-Wen Cheng
- Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Li-Wen Chiu
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yang-Yi Chen
- Department of Dermatology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, Department of Dermatology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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13
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Zhang Y, Zhang X, Chen F, Xu S, Shi Y, Ding Y. Subungual haemorrhage in a patient with pemphigus vulgaris. Eur J Dermatol 2023; 33:178-179. [PMID: 37431129 DOI: 10.1684/ejd.2023.4463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
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14
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Wang J, Jing J, Shi X, Jiang S. Pemphigus foliaceus complicated with Listeria monocytogenes infection and meningitis. Eur J Dermatol 2023; 33:165-167. [PMID: 37431122 DOI: 10.1684/ejd.2023.4423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
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15
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Raap U, Limberg MM, Kridin K, Ludwig RJ. Pruritus Is Associated with an Increased Risk for the Diagnosis of Autoimmune Skin Blistering Diseases: A Propensity-Matched Global Study. Biomolecules 2023; 13:biom13030485. [PMID: 36979421 PMCID: PMC10046528 DOI: 10.3390/biom13030485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/08/2023] [Accepted: 02/22/2023] [Indexed: 03/09/2023] Open
Abstract
Autoimmune bullous skin diseases (AIBDs), such as bullous pemphigoid (BP) and pemphigus, are characterized and caused by autoantibodies targeting structural proteins. In BP, clinical experience and recent systematic evaluation identified pruritus to be common and an important cause of impaired quality of life. Furthermore, chronic pruritus may be the sole clinical symptom of BP. In pemphigus, a retrospective study recently documented a high prevalence of pruritus. The temporal relation between pruritus and BP/pemphigus are, however, unknown. Likewise, the presence of pruritus in AIBDs other than BP and pemphigus is unknown. To address this, we performed propensity-matched retrospective cohort studies using TriNetX, providing real-world patient data to (i) assess the risk to develop AIBDs following the diagnosis of pruritus and (ii) vice versa. We assessed this in eight AIBDs: BP, mucous membrane pemphigoid (MMP), epidermolysis bullosa acquisita, dermatitis herpetiformis, lichen planus pemphigoides (LPP), pemphigus vulgaris, pemphigus foliaceous, and paraneoplastic pemphigus (PNP). For all AIBDs, pruritus was associated with an increased risk for the subsequent diagnosis of each of the eight investigated AIBDs in 1,717,744 cases (pruritus) compared with 1,717,744 controls. The observed hazard ratios ranged from 4.2 (CI 3.2–5.5; p < 0.0001) in MMP to 28.7 (CI 3.9–211.3; p < 0.0001) in LPP. Results were confirmed in two subgroup analyses. When restricting the observation time to 6 months after pruritus onset, most HRs noticeably increased, e.g., from 6.9 (CI 6.2–7.9; p < 0.0001) to 23.3 (CI 17.0–31.8; p < 0.0001) in BP. Moreover, pruritus frequently developed following the diagnosis of any of the eight AIBDs, except for PNP. Thus, all AIBDs should be considered as differential diagnosis in patients with chronic pruritus.
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Affiliation(s)
- Ulrike Raap
- Clinics of Dermatology and Allergy, Division of Experimental Allergy and Immunodermatology, University of Oldenburg, 26129 Oldenburg, Germany
| | - Maren M. Limberg
- Clinics of Dermatology and Allergy, Division of Experimental Allergy and Immunodermatology, University of Oldenburg, 26129 Oldenburg, Germany
| | - Khalaf Kridin
- Lübeck Institute for Experimental Dermatology, University of Lübeck, 23560 Lübeck, Germany
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed 5290002, Israel
- Unit of Dermatology and Skin Research Laboratory, Barch Padeh Medical Center, Poriya 15208, Israel
| | - Ralf J. Ludwig
- Lübeck Institute for Experimental Dermatology, University of Lübeck, 23560 Lübeck, Germany
- Department of Dermatology, University Clinic of Schleswig-Holstein, 23560 Lübeck, Germany
- Correspondence: ; Tel.: +49-451-500-41686
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16
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Wei C, He TH, Zhuang JL, Zhou D. [Paraneoplastic pemphigus associated with chronic lymphocytic leukemia: a case report]. Zhonghua Nei Ke Za Zhi 2022; 61:1369-1372. [PMID: 36456521 DOI: 10.3760/cma.j.cn112138-20211222-00905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- C Wei
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - T H He
- Department of Internal Medicine, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - J L Zhuang
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
| | - Daobin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China
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17
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Hui HZ, Guo HX, Wang YJ, Shi BJ. Rare Case of Paraneoplastic Pemphigus Associated With Prostatic Cancer. Am J Dermatopathol 2022; 44:940-942. [PMID: 36197045 DOI: 10.1097/dad.0000000000002313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 08/13/2022] [Indexed: 11/18/2022]
Abstract
ABSTRACT The combination of paraneoplastic pemphigus and prostate cancer is extremely unusual and has not been reported yet. Paraneoplastic pemphigus is caused by tumor-induced autoantibodies, which cause damage to the skin and mucosa. The essential treatment is active tumor control. Our patient received a robot-assisted radical prostatectomy and glucocorticoid therapy to improve his condition and relieve his skin lesions.
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Affiliation(s)
- Hai-Zhen Hui
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China
- Guizhou University of Traditional Chinese Medicine, Guiyang, PR China; and
| | | | - Ying-Jun Wang
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China
- Guizhou University of Traditional Chinese Medicine, Guiyang, PR China; and
| | - Bing-Jun Shi
- Department of Dermatology, Chongqing Hospital of Traditional Chinese Medicine (Chongqing Clinical Research Center for Dermatology, Chongqing Key Laboratory of Integrative Dermatology Research), District Yuzhong, Chongqing, PR China
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18
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Chai K, Zhu R, Luo F, Shi Y, Liu M, Xiao Y, Xiao R. Updated Role of High-frequency Ultrasound in Assessing Dermatological Manifestations in Autoimmune Skin Diseases. Acta Derm Venereol 2022; 102:adv00765. [PMID: 36000997 PMCID: PMC9558316 DOI: 10.2340/actadv.v102.1969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Autoimmune skin diseases are a group of disorders that arise due to the dysregulated immune system attacking self-antigens, causing multiple tissue and organ lesions. With disease progression, the physical and psychological health of patients may be seriously damaged. High-frequency ultrasound is non-invasive, reproducible, and suitable for visualizing the fine structure of external organs. The usage of high-frequency ultrasound has increased in recent years in the auxiliary diagnosis and monitoring of various skin diseases; it serves as a promising tool for dermatological disease assessment. This review summarizes the characteristics of high-frequency ultrasound imaging in common autoimmune skin diseases, including systemic lupus erythematosus, scleroderma, psoriasis, dermatomyositis, and pemphigus/pemphigoid. The objective of this review is to provide new ideas and strategies for dermatologists to diagnose and track the prognosis of autoimmune skin diseases.
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Affiliation(s)
| | | | | | | | | | - Yangfan Xiao
- Department of Anesthesiology, The Second Xiangya Hospital of Central South University, Changsha, China.
| | - Rong Xiao
- Department of Dermatology, The Second Xiangya Hospital of Central South University, Changsha, China.
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Rabinovich OF, Abramova ES, Umarova KV, Iskandaryan MA. [The study of microbiota in patients with bullous lesions of the oral mucosa]. Stomatologiia (Mosk) 2022; 101:18-21. [PMID: 35640174 DOI: 10.17116/stomat202210103118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
THE AIM OF THE STUDY The study by the method of tissue polymerase chain reaction of the species composition of the microbiota of lesions of the oral mucosa in patients with bullous lesions. MATERIAL AND METHODS Biopsy specimens of the oral mucosa of 51 patients were studied by the polymerase chain reaction method, of which 14 patients with pemphigus vulgaris, 17 patients with pemphigoid bullosa, and 20 patients with the bullous form of ruber lichen planus. 4 types of microorganisms have been identified - Fusobacterium, Streptococcus pneumoniae, Candida albicans, Ureaplasma spp. and viruses - Human Papillomavirus 16, Epstein-Barr virus and Citomegalovirus. RESULTS In the study of the microbiota of bullous lesions, associations of microorganisms and viruses were established in a significant number of cases. Associations of Str.pneumoniae and C. albicans were quite common in patients with pemphigus vulgaris in 26.3%, pemphigoid bullosa in 20.0%, and in patients with the bullous form of ruber lichen planus in 14.3% of cases. In patients with pemphigus vulgaris, the association of Str.pneumoniae, C. albicans and EBV was noted in 31.6% of cases. In patients with the bullous form of ruber lichen planus in a high percentage of cases (28.6%), the associations of Str. pneumoniae, EBV and CMV. CONCLUSION Identification at earlier stages of management of patients with bullous lesions Str. pneumoniae, Candida albicans, and Fusobacterium associated with herpes viruses should be regarded as one of the triggering mechanisms of an autoimmune conflict, which subsequently causes a specific clinical picture of these diseases.
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Affiliation(s)
- O F Rabinovich
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - E S Abramova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - K V Umarova
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - M A Iskandaryan
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Kuriyama K, Kitamura Y, Tsuji T, Nishikawa R, Nagata H, Ohshiro M, Sugitani M, Hirakawa Y, Matsumoto Y, Iwai T, Uchiyama H. Successful treatment of paraneoplastic pemphigus and bronchiolitis obliterans associated with follicular lymphoma with obinutuzumab and bendamustine. Curr Probl Cancer 2021; 46:100813. [PMID: 34844771 DOI: 10.1016/j.currproblcancer.2021.100813] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We herein report the rare case of a 72-year-old female who presented with paraneoplastic pemphigus (PNP) and bronchiolitis obliterans (BO) associated with follicular lymphoma (FL), who was successfully treated with obinutuzumab (GA101; G) and bendamustine (B). The patient had severe erosive stomatitis and bilateral conjunctival hyperemia that persisted for more than 6 months. A huge mass was found in the abdominal cavity, and a biopsy revealed grade 1 FL (stage IV). Based on a lip biopsy result, the patient was diagnosed with PNP associated FL. The patient received bendamustine and obinutuzumab (BG) chemotherapy and FL and PNP responded very well, but BO was additionally associated during the course of BG. BO progressed without exacerbation as BG therapy progressed to a 2 year maintenance therapy with G, and combination of azithromycin, inhaled bronchodilator therapy, and corticosteroid. She was followed up at the outpatient department with no pulmonary function decline or FL and PNP recurrence. Our case suggests that BG could be a promising treatment option for PNP and BO.
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Affiliation(s)
- Kodai Kuriyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan. kuriyama-_-kodai-@hotmail.co.jp
| | - Yoshimi Kitamura
- Department of Dermatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan; Department of Dermatology, Kyoto City Hospital, Kyoto, Japan
| | - Taisuke Tsuji
- Department of Respiratory Medicine, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Rina Nishikawa
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hiroaki Nagata
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Muneo Ohshiro
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Mio Sugitani
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yoshiko Hirakawa
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Yosuke Matsumoto
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Toshiki Iwai
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
| | - Hitoji Uchiyama
- Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan
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21
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Fakhraei S, Layegh P, Darchini-Maragheh E, Tayyebi Meybodi N. Oral verrucous carcinoma arising from pemphigus vulgaris: A rare coincidence. Oral Oncol 2021; 124:105513. [PMID: 34518111 DOI: 10.1016/j.oraloncology.2021.105513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 08/21/2021] [Accepted: 08/24/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Sara Fakhraei
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Pouran Layegh
- Cutaneous Leishmaniasis Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | | | - Naser Tayyebi Meybodi
- Department of Pathology, Emam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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22
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Honda R, Fujii K, Utatsu K, Kanekura T. Pemphigus vulgaris associated with scleritis. Clin Exp Dermatol 2021; 46:1105-1106. [PMID: 33655515 DOI: 10.1111/ced.14629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 02/26/2021] [Indexed: 01/13/2023]
Affiliation(s)
- R Honda
- Departments of, Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - K Fujii
- Departments of, Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - K Utatsu
- Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - T Kanekura
- Departments of, Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Wang D, Chen Z. Paraneoplastic pemphigus associated with small lymphocytic lymphoma: A case report. Medicine (Baltimore) 2021; 100:e24039. [PMID: 33466152 PMCID: PMC7808545 DOI: 10.1097/md.0000000000024039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/28/2020] [Accepted: 12/04/2020] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Paraneoplastic pemphigus (PNP) is a life-threatening autoimmune blistering disease associated with underlying neoplasms. Currently, this disease is very difficult to treat. PATIENT CONCERNS We reported a rare case of paraneoplastic pemphigus associated with small lymphocytic lymphoma responsive to desmoglein 3 (Dsg3) and bullous pemphigoid (BP) antigen 180. DIAGNOSES The initial diagnosis was hypothesized to be Stevens-Johnson syndrome based on the severe mucosal erosion and polymorphous skin lesions. However, the histopathological examination of the skin biopsy and immunology revealed PNP. INTERVENTIONS Anti-tumor therapy, immunosuppression and anti-infective therapy were administered. OUTCOMES After a series of treatments, the skin lesions had been alleviated remarkably. Enzyme-linked immunoassays indices for Dsg3 and bullous pemphigoid antigen 180 decreased (Dsg3, 32; bullous pemphigoid antigen 180, 70.44). Unfortunately, 2 months later, the patient suffered respiratory failure due to the lung impairment of small lymphocytic lymphoma and infection. Eventually, the patient chose to be discharged from the hospital and lost the opportunity for follow-up treatment as he could not afford the expensive treatment costs. LESSONS It is highly susceptible to misdiagnosis due to polymorphous skin lesions. In this case, it was also initially misdiagnosed as Stevens-Johnson syndrome. Therefore, we should pay great attention to differential diagnosis. When refractory stomatitis and mucosal erosions occur, the possibility of PNP should be considered first. At the same time, pathology, immunology and other related tests as well as the examination of primary tumors should be carried out as soon as possible.
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Affiliation(s)
- Dafen Wang
- The second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, China
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Luo N, Tan S, Li X, Liu S, Singh S, Chen M, Yang W, He Y, Chen C, Liang M. Pulmonary nocardiosis in a patient with pemphigus foliaceus: case report and literature review. BMC Infect Dis 2021; 21:8. [PMID: 33407179 PMCID: PMC7788831 DOI: 10.1186/s12879-020-05673-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/30/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Nocardiosis is an uncommon opportunistic infection seen in immunocompromised patients or those with a dysfunctional immune system. Nocardia asteroides infection in patients with Pemphigus foliaceus (PF) has never been reported. CASE PRESENTATION We report an interesting case of nocardiosis-characterized by pulmonary intra-cavitary infection, in a 54-year-old man with PF and diabetes mellitus. The man finally recovered from the infection. CONCLUSIONS This is the first case reporting pulmonary nocardiosis in a patient with PF. We recommend that physicians be aware of nocardiosis in patients with pemphigus as a possible cause of underlying infectious disease to avoid misdiagnoses and mismanagement.
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Affiliation(s)
- Ning Luo
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | - Shifan Tan
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | - Xiaocai Li
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | - Si Liu
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China
| | | | - Mafeng Chen
- Department of Otorhinolaryngology, Maoming People's Hospital, Maoming, China
| | - Weiye Yang
- Department of Laboratory Medicine, Maoming People's Hospital, Maoming, China
| | - Yanhong He
- Department of Scientific Research, Maoming People's Hospital, Maoming, China
| | - Chunna Chen
- Department of Dermatology, Maoming People's Hospital, Maoming, China
| | - Min Liang
- Department of Respiratory and Critical Care Medicine, Maoming People's Hospital, MaoNanQu, WeiMing Road 101 Hao, Maoming City, Guangdong, China.
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Qu C, Tian X, Ma Y, Xie X, Wang M, Dong Y, Zhang J, Liu P, Yang Y. Multidisciplinary diagnosis and treatment of recurrent follicular dendritic cell sarcoma in abdomen: A case report. Medicine (Baltimore) 2020; 99:e23588. [PMID: 33371089 PMCID: PMC7748373 DOI: 10.1097/md.0000000000023588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 11/09/2020] [Indexed: 12/26/2022] Open
Abstract
RATIONALE Follicular dendritic cell sarcoma (FDCS) is a rare malignant tumor derived from follicular dendritic cells, and is often associated with Castleman disease. Here we present a rare case of paraneoplastic pemphigus (PNP) with FDCS which required multidisciplinary approach for the diagnosis and treatment. PATIENT CONCERNS A 28-year-old Chinese female had FDCS recurrence, and primary clinical manifestation was PNP. DIAGNOSES PNP with FDCS. INTERVENTIONS The patient received gamma globulin infusion, took anlotinib, and underwent plasma exchange therapy. OUTCOMES The skin lesions recovered and there was no evidence of tumor recurrence. LESSONS The diagnosis and management of PNP with FDCS require close cooperation among surgeons, dermatologists, hematologists, otolaryngologists, oncologists, radiologists, pathologists, and respiratory doctors. The interesting clinical manifestations of this patient provide a multifaceted approach to the investigation of the interactions among FDCS, Castleman disease, and PNP.
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Affiliation(s)
| | | | | | | | | | | | - Jixin Zhang
- Department of Pathology, Peking University First Hospital, Beijing, People's Republic of China
| | - Ping Liu
- Department of Pathology, Peking University First Hospital, Beijing, People's Republic of China
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26
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Kridin K, Jones VA, Patel PM, Zelber-Sagi S, Hammers CM, Damiani G, Amber KT, Cohen AD. Patients with pemphigus are at an increased risk of developing rheumatoid arthritis: a large-scale cohort study. Immunol Res 2020; 68:373-378. [PMID: 33159312 PMCID: PMC7674560 DOI: 10.1007/s12026-020-09160-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 10/22/2020] [Indexed: 12/11/2022]
Abstract
Data regarding the association between pemphigus and rheumatoid arthritis (RA) is inconclusive and yet to be firmly established. In the current study, we aimed to evaluate the risk of developing RA during the course of pemphigus. A large-scale population-based longitudinal cohort study was conducted to evaluate the hazard ratio (HR) of RA among 1985 patients with pemphigus relative to 9874 age-, sex-, and ethnicity-matched control subjects. A multivariate Cox regression model was utilized. The incidence of RA was 1.07 (95% CI, 0.62-1.72) and 0.36 (95% CI, 0.24-0.52) per 1000 person-years among patients with pemphigus and controls, respectively. The lifetime prevalence of RA was 2.3% (95% CI, 1.7-3.1%) among cases and 1.8% (95% CI, 1.5-2.0%) among controls. Patients with pemphigus were more than twice as likely to develop RA as compared to control subjects (adjusted HR, 2.54; 95% confidence interval [CI], 1.31-4.92). The increased risk was robust to a sensitivity analysis that included only cases managed by pemphigus-related systemic medications (adjusted HR, 2.56; 95% CI, 1.30-5.05). In conclusion, pemphigus is associated with an increased risk of RA. Physicians treating patients with pemphigus should be aware of this possible association. Further research is required to better understand the mechanism underlying this association.
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Affiliation(s)
- Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Virginia A Jones
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | - Payal M Patel
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Christoph M Hammers
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Giovanni Damiani
- Clinical Dermatology, IRCCS Istituto Ortopedico Galeazzi, 20161, Milan, Italy
| | - Kyle T Amber
- Department of Dermatology, University of Illinois at Chicago, Chicago, IL, USA
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Abstract
Pemphigus and its variants, viz., vulgaris, foliaceous, vegetans, Ig A pemphigus, paraneoplastic pemphigus and Senear-Usher syndrome are rare autoimmune blistering diseases of the skin and/or mucous membranes. The autoantibodies involved in the pathogenesis of pemphigus against desmoglein result in the breach of the skin and mucosal barrier, which acts as the first line of defence against pathogens. In this paper we underscore the importance of the integumentary system as a shield against the acquisition as well as transmission of SARS-CoV-2 virion. We have also made an attempt to delineate the various treatment modalities available and the viral-drug dynamics involved in choosing the optimum therapeutic modality.
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Affiliation(s)
- Manoj Pawar
- Department of Dermatology, MVP's Dr. V.P. Medical College & Hospital & Research center, Nashik, India
| | - Mehak Singh
- Department of Dermatology, JK Medical College & LN Hospital, Bhopal, India.
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28
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Phan K, Ramachandran V, Smith SD. Association between pemphigus and psoriasis: a systematic review and meta-analysis. Dermatol Online J 2020; 26:13030/qt5g78q4f4. [PMID: 32941727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/15/2020] [Indexed: 06/11/2023] Open
Abstract
Pemphigus has been associated with other autoimmune and autoinflammatory disorders. Specifically, some case reports in the literature document coexistence of pemphigus with psoriasis, but this association is lacking larger scale investigation. With this in mind, we conducted a systematic review and meta-analysis to evaluate the association between pemphigus and psoriasis. In doing so, we found an association between the two conditions. Pemphigus was more common in patients with psoriasis than in controls (OR 2.64, 95% CI 1.24-5.59, P=0.01), with heterogeneity (I2=94%). We go on to propose pathophysiologic mechanisms and its relevance for diagnostic and management considerations.
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Affiliation(s)
- Kevin Phan
- University of New South Wales, Sydney Department of Dermatology, Liverpool Hospital, Sydney.
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Lehr S, Heyne S, Berndt K, Beissert S, Abraham S, Günther C. Human Papilloma Virus-positive Squamous Cell Carcinoma of the Oropharynx Arising in Pemphigus Vulgaris. Acta Derm Venereol 2020; 100:adv00132. [PMID: 32250440 PMCID: PMC9137360 DOI: 10.2340/00015555-3478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sophia Lehr
- Department of Dermatology, University Hospital Dresden, DE-01307 Dresden, Germany. E-mail:
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30
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Hsu YM, Fang HY, Lin CL, Shieh SH. The Risk of Depression in Patients with Pemphigus: A Nationwide Cohort Study in Taiwan. Int J Environ Res Public Health 2020; 17:ijerph17061983. [PMID: 32192212 PMCID: PMC7142767 DOI: 10.3390/ijerph17061983] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 03/10/2020] [Indexed: 11/29/2022]
Abstract
Pemphigus is a chronic dermatological disorder caused by an autoimmune response and is associated with a high proportion of comorbidities and fatalities. The aim of this study was to investigate the risk of depression in patients with pemphigus. Data were derived from the National Health Insurance Research Database recorded during the period 2000–2010 in Taiwan. Multivariate Cox proportional hazards regression models were used to analyze the data and assess the effects of pemphigus on the risk of depression after adjusting for demographic characteristics and comorbidities. Patients with pemphigus were 1.98 times more likely to suffer from depression than the control group (pemphigus, adjusted HR: 1.99, 95% CI = 1.37–2.86). People aged ≥65 years were 1.69 times more likely to suffer from depression than those aged 20–49 years (≥65 years, adjusted HR: 1.42, 95% CI = 0.92–2.21). Female and male patients with pemphigus were respectively 2.02 and 1.91 times more likely to suffer from depression than the control group (female, adjusted HR: 2.09, 95% CI = 1.24–3.54; male, adjusted HR: 1.87, 95% CI = 0.97–3.60). People with HTN, hyperlipidemia, asthma/COPD, and chronic liver disease were respectively 1.73, 2.3, 2.2, and 1.69 times more likely to suffer from depression than those without these comorbidities (HTN, adjusted HR: 0.75, 95% CI = 0.41–1.42; hyperlipidemia, adjusted HR: 1.48, 95% CI = 0.78–2.82; asthma/COPD, adjusted HR: 1.4, 95% CI = 0.72–2.69; and chronic liver disease, adjusted HR: 1.61, 95% CI = 1.07–2.43). There was a significant association between pemphigus and increased risk of depression. Female patients had a higher incidence of depression.
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Affiliation(s)
- Yi-Min Hsu
- Department of Public Health, China Medical University, Taichung 40447, Taiwan;
- Department of Nursing, China Medical University Hospital, Taichung 40447, Taiwan
| | - Hsin-Yu Fang
- Department of dermatology, China Medical University Hospital, Taichung 40447, Taiwan
- Correspondence: (H.-Y.F.); (S.-H.S.); Tel.: +886-4-22052121 (ext. 4661) (H.-Y.F.); +886-4-22053366 (ext. 6631) (S.-H.S.)
| | - Cheng-Li Lin
- Management Office for Health Data, China Medical University Hospital, Taichung 40447, Taiwan;
| | - Shwn-Huey Shieh
- Department of Health Services Administration, China Medical University, Taichung 40447, Taiwan
- Department of Nursing, Asia University, Taichung 41354, Taiwan
- Correspondence: (H.-Y.F.); (S.-H.S.); Tel.: +886-4-22052121 (ext. 4661) (H.-Y.F.); +886-4-22053366 (ext. 6631) (S.-H.S.)
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31
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Chovatiya R, Silverberg JI. Association of pemphigus and pemphigoid with osteoporosis and pathological fractures. Arch Dermatol Res 2019; 312:263-271. [PMID: 31741052 DOI: 10.1007/s00403-019-02010-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/05/2019] [Indexed: 01/25/2023]
Abstract
Patients with pemphigus and bullous pemphigoid (BP) have potential risk factors for osteoporosis and/or fractures. To determine whether pemphigus and BP are associated with osteoporosis and fractures in the US, a cross-sectional study of 198,102,435 adults was performed, including 4506 with pemphigus and 8864 with BP from the 2006-2012 National Emergency Department Sample, a 20% sample of emergency care visits throughout the US. Pemphigus was associated with higher odds (multivariate logistic regression; adjusted odds ratio [95% confidence intervals]) of osteopenia (2.20 [1.59-3.05]), osteoporosis (2.54 [2.16-2.98]), osteomalacia (29.70 [4.05-217.83]), and pathological fractures (2.04 [1.42-2.91]). BP was associated with osteoporosis (1.55 [1.39-1.73]) and pathological fractures (1.52 [1.22-1.88]). When compared to BP, pemphigus was associated with higher odds of osteopenia (1.59 [1.06-2.41]), osteoporosis (1.38 [1.18-1.63]), and fractures (1.26 [1.04-1.53]), particularly of the ulna and radius (3.17 [1.23-8.17]). Patients with pemphigus or BP as well as long-term systemic corticosteroid use had highest odds of osteoporosis and fractures. No data were available on treatments for pemphigus or BP. Pemphigus and BP were associated with osteopenia, osteoporosis, and pathologic fractures. Patients with PEM and BP may benefit from increased screening for osteoporosis and interventions to prevent fractures.
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Affiliation(s)
- Raj Chovatiya
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Suite 1600, 676 N. St. Clair St., Chicago, IL, 60611, USA.
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, 20037, USA
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32
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Bhange SA, Bhansali M, Shaikh T, Ajgaonkar U. Rare case of peristomal pemphigus vulgaris in an operated case of carcinoma of the rectum. BMJ Case Rep 2019; 12:e230956. [PMID: 31712232 PMCID: PMC6855877 DOI: 10.1136/bcr-2019-230956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2019] [Indexed: 11/04/2022] Open
Abstract
Pemphigus vulgaris (PV), in association with malignancy of the rectum, is a very rare presentation. We present here a case of a 58-year-old woman presenting with atypical skin eruptions in the peristomal area, which gradually progressed to her entire body. These lesions were later diagnosed to be PV. She developed these lesions in her postoperative period following an anterior resection with a covering ileostomy for her rectal malignancy. She had received neoadjuvant chemo+radiotherapy for her malignancy.
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Affiliation(s)
- Snehal A Bhange
- General Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Mehul Bhansali
- Surgical Oncology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Tanveer Shaikh
- General Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
| | - Utkarsh Ajgaonkar
- General Surgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
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Schauer F, Steinke H, Thoma K, Kiritsi D. Transition from Bullous Pemphigoid to Pemphigus Foliaceus: Intermolecular Epitope Spreading Thirteen Years after Initial Diagnosis. Acta Derm Venereol 2019; 99:1029-1030. [PMID: 31282977 DOI: 10.2340/00015555-3250] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Franziska Schauer
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, DE-79104 Freiburg, Germany.
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Toh JJ, Lim YL, Yew YW. Characteristics and Management of Autoimmune Bullous Disease in Psoriasis Patients. Ann Acad Med Singap 2019; 48:301-305. [PMID: 31737896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
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35
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Endo H, Rees TD, Niwa H, Kuyama K, Oshima M, Serizawa T, Tanaka S, Komiya M, Ito T. Acantholysis may precede elevation of circulating anti-desmoglein 3 antibody levels in pemphigus vulgaris presenting with desquamative gingivitis. Clin Exp Dent Res 2019; 5:219-224. [PMID: 31249702 PMCID: PMC6585872 DOI: 10.1002/cre2.174] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 01/22/2019] [Indexed: 11/16/2022] Open
Abstract
Pemphigus vulgaris (PV) is an autoimmune, blistering disease that affects the mucosa and skin. The current theory favors the concept that anti-desmoglein (Dsg) 3 autoimmunity is the only pathogenic event needed to induce acantholysis. However, a few cases of active PV in the oral cavity had no detectable anti-Dsg 3 antibody. The aim of this study was to evaluate the differences in clinical and laboratory findings, whether or not the anti-Dsg 3 antibodies were present. This study was based on a retrospective review of 10 PV cases. The evaluation of the circulating autoantibody titers to Dsg 3 was conducted by using enzyme-linked immunosorbent assay (ELISA). An index value of 20 or more was used as the cutoff for a positive reaction. Only five of the 10 PV cases had a positive Dsg 3 ELISA. There were no differences in clinical, cytological, histopathological, and direct immunofluorescence findings, whether or not the anti-Dsg 3 antibodies were present. Of the five patients with a negative reaction at the time of diagnosis, the Dsg 3 ELISA became positive in the follow-up period in three cases. In the remaining two cases, the Dsg 3 ELISA was consistently negative for 18 months. Dsg 3 ELISA was negative early in some PV cases. Therefore, PV acantholysis may precede the elevation of circulating anti-Dsg 3 antibody levels. The diagnosis of PV should be considered based on comprehensive clinical, histopathological, and immunofluorescent criteria.
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Affiliation(s)
- Hiroyasu Endo
- Department of Oral DiagnosisNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Terry D. Rees
- Department of PeriodonticsTexas A&M College of DentistryDallasTexasUSA
| | - Hideo Niwa
- Department of Head and Neck SurgeryNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Kayo Kuyama
- Department of PathologyNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Maya Oshima
- Department of Oral SurgeryNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Tae Serizawa
- Department of Oral SurgeryNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Shigeo Tanaka
- Department of Oral SurgeryNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Masamichi Komiya
- Department of Oral SurgeryNihon University School of Dentistry at MatsudoMatsudoJapan
| | - Takanori Ito
- Department of Oral DiagnosisNihon University School of Dentistry at MatsudoMatsudoJapan
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36
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Abstract
Painful oral vesiculoerosive diseases (OVD) include lichen planus, pemphigus vulgaris, mucous membrane pemphigoid, erythema multiforme, and recurrent aphthous stomatitis. OVD lesions have an immunopathic cause. Treatment is aimed at reducing the immunologic and the following inflammatory response. The mainstay of OVD management is topical or systemic corticosteroids to include topical triamcinolone, fluocinonide, and clobetasol, whereas systemic medications used in practice can include dexamethasone, prednisone, and prednisolone. Oral herpetic lesions can be primary or recurrent. If management is desired, they can be treated by topical or systemic antiviral drugs. Topical antiviral creams include prescription acyclovir, penciclovir and over-the-counter docosanol.
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Abstract
Pemphigus vulgaris (PV) is a rare autoimmune bullous disease which affects the skin and mucous membranes. Oesophageal involvement is rare and has previously been limited to case reports and case series. A recent large case series of 477 PV patients showed that 26/477 (5.4%) had symptomatic oesophageal involvement. We present the case of a 54-year-old Somalian lady with a 10-year history of cutaneous PV, currently in remission, who developed dysphagia and odynophagia and was subsequently found to have oesophageal PV involvement with multiple flaccid bullae which were positive for anti-DSG3 antibodies on in-direct immunofluorescence. She had her treatment switched from azathioprine to mycophenolate and prednisolone, leading to resolution of her symptoms.
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Affiliation(s)
- Michael McFarlane
- Department of Gastroenterology, UHCW, Clifford Bridge Road, Coventry, CV2 2DX, UK.
| | - Ayesha Azam
- Department of Histopathology, UHCW, Clifford Bridge Road, Coventry, CV2 2DX, UK
| | - David Snead
- Department of Histopathology, UHCW, Clifford Bridge Road, Coventry, CV2 2DX, UK
| | - Ben Disney
- Department of Gastroenterology, UHCW, Clifford Bridge Road, Coventry, CV2 2DX, UK
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38
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Altun E, Yaylı S, Selçuk LB, Arıca DA, Bahadır S. Clinical and Demographic Characteristics of Pemphigus Vulgaris Patients. Acta Dermatovenerol Croat 2018; 26:119-125. [PMID: 29989867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Pemphigus is an autoimmune disease characterized by intraepithelial bullae and erosions in the skin and mucosa. We aimed to evaluate the clinical and demographic characteristics of pemphigus vulgaris (PV) patients who presented to our Department. Patients who presented to our Department between May 2013 and May 2014, were examined dermatologically and diagnosed with PV based on clinical, histological and direct immunofluorescent findings. Name, family name, and gender of the patients, their complaint at presentation, onset time and location of the lesions, the number of lesions, systemic treatments received by patients and patients' medication histories were recorded. Forty-nine PV patients were included in our study. Among these, 22 (44.9%) were female and 27 (55.1%) male. The mean age of the patients was 53.28±14.70 (range 23 to 79) years. The mean duration of the disease was 44.45±45.68 (range 1 to 180) months. The most common complaints at presentation were lesion in the mouth (47/49) and lesion/blister in the skin (39/49). The onset locations of the lesions were the oropharynx (63.3%), the skin and oropharynx combined (16.3%), the skin (18.4%) and the anus (2%). The chronological order for the sites of involvement were as follows: first the oropharynx then the skin (42.9%), first the skin then the oropharynx (18.4%), and the oropharynx and the skin combined (16.3%). Ten patients (20.4%) had mucosal involvement and one (2%) had skin involvement alone, whereas both mucosal and skin involvements were observed in 38 patients (77.6%). Forty-seven patients (95.9%) had not used any medications that could have led to pemphigus. One patient had a history of beta-blocker use and another had a history of ACE inhibitor prior to the emergence of the pemphigus lesions. The clinical and demographic results of the PV patients in our region were consistent with those from other studies.
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Affiliation(s)
- Ece Altun
- Ece Altun, MD. Muş State Hospital . Department of Dermatology . 49100 Muş. Turkey;
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39
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Mullick S, Pan YJF, Desai A, Singh S, Ekong E. Recurrent Oral Ulcers in a Refugee. Am Fam Physician 2018; 97:411-412. [PMID: 29671544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Sahil Mullick
- Creighton University Family Medicine Residency, Omaha, NE, USA
| | | | - Anand Desai
- Creighton University Family Medicine Residency, Omaha, NE, USA
| | - Sonal Singh
- Creighton University Family Medicine Residency, Omaha, NE, USA
| | - Essien Ekong
- Creighton University Family Medicine Residency, Omaha, NE, USA
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40
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Chandan N, Lake EP, Chan LS. Unusually extensive scalp ulcerations manifested in pemphigus erythematosus. Dermatol Online J 2018; 24:13030/qt1vd4j2t2. [PMID: 29469763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 02/13/2018] [Indexed: 06/08/2023] Open
Abstract
Senear-Usher Syndrome, or pemphigus erythematosus, is an autoimmune skin blistering disorder with an overlapping clinical presentation of pemphigus foliaceus and lupus erythematosus. Lesions typically involve the scalp, face, and upper chest or back. This case study focuses on a patient who presentedwith progressive scalp ulcers, hyperpigmentation, and eroded plaques with overlying hemorrhagic crust. Pemphigus erythematosus was diagnosedwith direct immunofluorescence, demonstrating immunoglobulin G and complement deposition both intercellularly and at the dermoepidermal junction. The patient is continuing treatment with systemicsteroids and steroid-sparing immunosuppressants.
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Affiliation(s)
- Neha Chandan
- University of Illinois College of Medicine, Chicago, Illinois.
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41
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Papakonstantinou E, Kapp A, Jonkman MF, Raap U. Intraepidermal neutrophilic dermatosis type of IgA pemphigus with circulating linear IgA disease antibodies associated with ulcerative colitis. J Eur Acad Dermatol Venereol 2018; 32:e10-e11. [PMID: 28653439 DOI: 10.1111/jdv.14436] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- E Papakonstantinou
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - A Kapp
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - M F Jonkman
- Department of Dermatology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - U Raap
- Department of Dermatology and Allergy, Faculty of Medicine and Health Sciences, University of Oldenburg, Klinikum Oldenburg AöR, Oldenburg, Germany
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42
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Hsu DY, Brieva J, Nardone B, West D, Silverberg JI. Association of pemphigus and systemic corticosteroid use with comorbid health disorders: A case-control study. Dermatol Online J 2017; 23:13030/qt1vk2m30m. [PMID: 29447647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/18/2018] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Pemphigus is a group of debilitating autoimmune blistering disorders associated with painful blisters of the skin and/or mucous membranes. Identification and management of the comorbiditiesof pemphigus is critically important to minimize morbidity and decrease mortality. OBJECTIVE To identify the comorbid health conditions of pemphigus vulgaris. METHODS This was a case-control study of 130 cases of pemphigus verified by a clinical and laboratory diagnosis and 390 age and sex-matched controls with complete follow-up at a large metropolitanquaternary care medical center. RESULTS Pemphigus vulgaris and its treatments were significantly associated with type 2 diabetes mellitus (adjusted odds ratio [95% confidence interval]: 5.68 [2.93-11.02]), hypertension (2.15 [1.25-3.71]), osteopenia (10.07 [3.72-27.25]), osteoporosis (4.19 [1.50-11.73]), cataracts (7.00 [1.81-27.07]), insomnia (15.00 [1.75-128.39]), and benign prostatic hyperplasia (6.84 [1.79-26.18]). A history of taking systemic corticosteroids was found in 76% of pemphigus vulgaris patients. There were significant statistical interactions between pemphigus vulgaris and a history of using systemic corticosteroids as predictors of diabetes mellitus type 2, hypertension, osteoporosis, and insomnia. CONCLUSIONS Safer and more effective systemic treatment options are needed for pemphigus to minimize iatrogenic complications of disease.
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Affiliation(s)
| | | | | | | | - Jonathan I Silverberg
- Departments of Dermatology, Preventive Medicine and Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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43
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Malamos D, Scully C. Clinical Challenges Q&A 26. Mouth and Skin Ulcerations. ACTA ACUST UNITED AC 2017; 43:988. [PMID: 29160055 DOI: 10.12968/denu.2016.43.10.988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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44
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Yeo PM, Ang CC. Jaw Pain in a Pemphigus Patient on Prednisolone, Mycophenolate Mofetil and Denosumab. Ann Acad Med Singap 2017; 46:329-330. [PMID: 28920136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Pei Ming Yeo
- Department of Dermatology, Changi General Hospital, Singapore
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45
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Affiliation(s)
- Mahaz Kayani
- Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Fulwood, Preston PR2 9HT, UK
| | - Arif M Aslam
- St Helens and Knowsley Teaching Hospitals NHS Trust, St Helens WA9 3DA, UK
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46
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Balighi K, Azizpour A, Sadeghinia A, Saeidi V. A Case Report of Paraneoplastic Pemphigus Associated With Retroperitoneal Inflammatory Myofibroblastic Tumor. Acta Med Iran 2017; 55:340-343. [PMID: 28724275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2017] [Indexed: 06/07/2023] Open
Abstract
Paraneoplastic pemphigus (PNP) is an autoimmune bullous disease associated with underlying neoplasms, both malignant and benign. The most constant clinical presentation of PNP is the presence of intractable stomatitis. Herein we present a 25-year-old male with a 3-month history of refractory stomatitis especially involving the lips and widespread vesiculobullous eruption on his trunk and extremities. The diagnosis of PNP was confirmed based on histological and serological results. Investigation for the underlying neoplasm revealed a retroperitoneal tumorous mass which was biopsied and diagnosed as the inflammatory myofibroblastic tumor (IMT). The tumor was surgically excised, and different treatment regimens were used to treat the mucocutaneous lesions. Skin lesions responded favorably to treatment, but oral stomatitis still persists which is the case in most PNP patients. This combination of PNP and IMT has rarely been reported in the literature. Treatment started with corticosteroid and rituximab then tumor excised.
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Affiliation(s)
- Kamran Balighi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arghavan Azizpour
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sadeghinia
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahide Saeidi
- Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran
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47
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Abstract
Autoantibodies to the desmosomal proteins desmoglein 1 and 3 cause pemphigus foliaceus and pemphigus vulgaris, which are characterised by keratinocyte dissociation (acantholysis) and intraepidermal blister formation. The passive transfer of pathogenic anti-desmoglein antibodies induces blisters in mice in vivo and the loss of keratinocyte adhesion in vitro. The pathogenetic mechanisms of acantholysis due to anti-desmoglein autoantibodies are not fully understood. However, recent studies have revealed that signalling-dependent and signalling-independent pathways are operative in the loss of cell adhesion. In this review, we focus on the pathomechanism of acantholysis due to autoantibodies to desmogleins and recent therapeutic approaches.
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Affiliation(s)
- Masutaka Furue
- Department of Dermatology, Kyushu University, Fukuoka, Japan
| | - Takafumi Kadono
- Department of Dermatology, St Marianna University School of Medicine, Kawasaki, Japan
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48
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Abstract
Pemphigus is a group of immune-mediated bullous disorders, which often cause fragile blisters and extensive lesions of the skin or mucous membranes, such as in the mouth. This disease could be life-threatening in some cases. During pregnancy, its condition will become more complicated due to the change in the mother’s hormone level and the effect of drug therapy on both the mother and her fetus. Thus, it will be more difficult to identify the clinical manifestations and to establish the treatment plan. In this article, we present a comprehensive review of pemphigus and pregnancy by analyzing 47 cases of pemphigus reported between 1966 and 2014, with diagnosis before or during pregnancy. The aim of this study is to make a comprehensive review of pemphigus and pregnancy, provide organized and reliable information for obstetricians, dermatologists, physicians, and oral medicine specialists.
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Affiliation(s)
- Lin Lin
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China. E-mail.
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49
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Chen IH, Mu SC, Tsai D, Chou YY, Wang LF, Wang LJ. Oral Ulcers as an Initial Presentation of Juvenile Pemphigus: A Case Report. Pediatr Neonatol 2016; 57:338-42. [PMID: 24295781 DOI: 10.1016/j.pedneo.2013.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Revised: 07/09/2013] [Accepted: 08/01/2013] [Indexed: 01/16/2023] Open
Abstract
Pemphigus vulgaris (PV) is an autoimmune disease in which the autoantibody, immunoglobulin G, is directed against the keratinocytes in the epidermis. The classic presentations of PV are flaccid vesicles or bullae over the oral mucosa, trunk, groin, and extremities. The age of onset is usually between 40 and 60 years, and cases of PV in children or adolescent patients are rare. Here, we present a 17-year-old boy who had painful oral ulcers for 3 months initially and bullae spreading to the whole body in the following days. Paraneoplastic pemphigus was another differential diagnosis due to the atypical appearance of the skin lesion. However, PV was confirmed by hematoxylin and eosin staining and immunofluorescence examination of the skin biopsy specimens. The patient had a good response to corticosteroid treatment and the immunosuppressive agent, rituximab.
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Affiliation(s)
- I-Hsuan Chen
- Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Shu-Chi Mu
- Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Dino Tsai
- Department of Dermatology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Yuh-Yu Chou
- Department of Pathology, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan
| | - Li-Fang Wang
- Department of Dermatology, National Taiwan University, Taipei, Taiwan
| | - Ling-Jen Wang
- Department of Pediatrics, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
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50
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Abstract
Paraneoplastic pemphigus (PNP) is an autoimmune blistering skin disease of humans that consists of characteristic skin lesions associated with concurrent neoplasia. in this study we provide histologic and serologic evidence to support a diagnosis of PNP in a dog with splenic sarcoma. Skin lesions consisted of widespread erosions involving haired skin, mucocutaneous junctions, and oral mucosa. Microscopic examination of skin and mucosae revealed lesions consistent with both pemphigus vulgaris and erythema multiforme. Immunoprecipitation confirmed that circulating IgG autoantibodies from this patient recognized five distinct antigens, presumed to represent epidermal plakins. Clinical, histopathologic, and immunologic findings in this patient were similar to those observed in human patients with PNP. The splenic neoplasia in this dog was diagnosed as a phenotypically variable spindle cell sarcoma. To date, only one other dog has been reported with PNP. This is the second reported case of canine PNP and the first patient in whom skin lesions were identified in association with splenic neoplasia.
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