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A case of pemphigus foliaceus aggravated in an irradiated area by radiotherapy against breast cancer.

Inadomi T - Indian J Dermatol (2015 Jan-Feb)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Division of Cutaneous Science, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan. E-mail: inadomy@nifty.com.

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Sir, There have been some case reports, in which autoimmune bullous diseases were induced or relapsed following radiotherapy... The titer of anti-desmoglein 1 antibodies (Dsg 1) was 113 (positive >9) and anti-desmoglein 3 antibodies were negative... Oral administration of 30 mg/day of prednisolone (PSL) effectively controlled the disease... The dose was then reduced and she had been stably controlled with 4-5 mg/day PSL for 2 years, when the titer of Dsg1 had decreased to around 50... In 2011, an annual physical examination found a breast cancer, which was in T2N0M0, on her left chest... IgG and C3 deposits were observed among the upper layer of keratinocytes through direct immunofluorescence and the titer of Dsg 1 was 45... The skin eruptions improved after administration of PSL at 30 mg/day... The patient is in complete remission, with oral PSL of 4 mg/day and the titer of Dsg 1 has remained around 50... Although it remains unclear whether the pathomechanisms by which autoimmune bullous diseases worsen locally following radiotherapy are the same as the pathomechanisms that induce the systemic lesions, these observations seem to suggest that radiotherapy can lead to systemic disorders in patients with bullous diseases... However, the dissociation between the titer of anti-Dsg and the local recurrence in our case suggests that the recurrence of PF is due to alterations restricted to the irradiated area, at least in the beginning... Considering the fact that autoimmune bullous diseases are often accompanied by internal malignancies, the possible risk of their recurrence following radiotherapy should be recognized.

No MeSH data available.


Related in: MedlinePlus

Scaly erythema, together with erosions was observed on her trunk, extremities, forehead and cheeks
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Figure 1: Scaly erythema, together with erosions was observed on her trunk, extremities, forehead and cheeks

Mentions: 65-year-old female patient visited our hospital in June 2009, complaining of scaly erythema on her face and trunk [Figure 1]. Based on histological findings and immunofluorescence observations, a diagnosis of pemphigus foliaceus (PF) was confirmed. The titer of anti-desmoglein 1 antibodies (Dsg 1) was 113 (positive >9) and anti-desmoglein 3 antibodies were negative. Oral administration of 30 mg/day of prednisolone (PSL) effectively controlled the disease. The dose was then reduced and she had been stably controlled with 4-5 mg/day PSL for 2 years, when the titer of Dsg1 had decreased to around 50. In 2011, an annual physical examination found a breast cancer, which was in T2N0M0, on her left chest. Electron beam therapy, totaling 50 Gy, controlled the cancer completely.


A case of pemphigus foliaceus aggravated in an irradiated area by radiotherapy against breast cancer.

Inadomi T - Indian J Dermatol (2015 Jan-Feb)

Scaly erythema, together with erosions was observed on her trunk, extremities, forehead and cheeks
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318076&req=5

Figure 1: Scaly erythema, together with erosions was observed on her trunk, extremities, forehead and cheeks
Mentions: 65-year-old female patient visited our hospital in June 2009, complaining of scaly erythema on her face and trunk [Figure 1]. Based on histological findings and immunofluorescence observations, a diagnosis of pemphigus foliaceus (PF) was confirmed. The titer of anti-desmoglein 1 antibodies (Dsg 1) was 113 (positive >9) and anti-desmoglein 3 antibodies were negative. Oral administration of 30 mg/day of prednisolone (PSL) effectively controlled the disease. The dose was then reduced and she had been stably controlled with 4-5 mg/day PSL for 2 years, when the titer of Dsg1 had decreased to around 50. In 2011, an annual physical examination found a breast cancer, which was in T2N0M0, on her left chest. Electron beam therapy, totaling 50 Gy, controlled the cancer completely.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Division of Cutaneous Science, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan. E-mail: inadomy@nifty.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, There have been some case reports, in which autoimmune bullous diseases were induced or relapsed following radiotherapy... The titer of anti-desmoglein 1 antibodies (Dsg 1) was 113 (positive >9) and anti-desmoglein 3 antibodies were negative... Oral administration of 30 mg/day of prednisolone (PSL) effectively controlled the disease... The dose was then reduced and she had been stably controlled with 4-5 mg/day PSL for 2 years, when the titer of Dsg1 had decreased to around 50... In 2011, an annual physical examination found a breast cancer, which was in T2N0M0, on her left chest... IgG and C3 deposits were observed among the upper layer of keratinocytes through direct immunofluorescence and the titer of Dsg 1 was 45... The skin eruptions improved after administration of PSL at 30 mg/day... The patient is in complete remission, with oral PSL of 4 mg/day and the titer of Dsg 1 has remained around 50... Although it remains unclear whether the pathomechanisms by which autoimmune bullous diseases worsen locally following radiotherapy are the same as the pathomechanisms that induce the systemic lesions, these observations seem to suggest that radiotherapy can lead to systemic disorders in patients with bullous diseases... However, the dissociation between the titer of anti-Dsg and the local recurrence in our case suggests that the recurrence of PF is due to alterations restricted to the irradiated area, at least in the beginning... Considering the fact that autoimmune bullous diseases are often accompanied by internal malignancies, the possible risk of their recurrence following radiotherapy should be recognized.

No MeSH data available.


Related in: MedlinePlus