Lam S, Stone M S, Goeken J A, Massicotte S J, Smith A C, Folberg R, Krachmer J H
Department of Ophthalmology, University of Iowa Hospitals and Clinics, Iowa City 52242.
Ophthalmology. 1992 Jan;99(1):108-13. doi: 10.1016/s0161-6420(92)32030-5.
A 77-year-old man with chronic conjunctivitis, acanthosis nigricans with pachydermatoglyphy, and pemphigus-like mucocutaneous lesions was found to have a well-differentiated bronchogenic squamous cell carcinoma. Histopathologic and immunofluorescence studies confirmed the diagnosis of paraneoplastic pemphigus. Skin lesions resolved with oral prednisone and azathioprine therapy, but the conjunctivitis and mucous membrane erosions persisted. The conjunctiva later became scarred with foreshortening of the fornices and development of symblepharon. External beam irradiation arrested the growth of the tumor but did not have any effect on the diseased conjunctiva and other mucous membranes. This case demonstrates that cicatrizing conjunctivitis with bullous mucocutaneous lesions may be a clinical sign associated with an occult neoplasm.
