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肺癌切除术后大疱性类天疱疮的缓解:一例副肿瘤性类天疱疮病例

Resolution of Bullous Pemphigoid Following Lung Cancer Resection: A Case of Paraneoplastic Pemphigoid.

作者信息

Youh Joohyung, Mizukami Takuya, Nagata Yuri, Ito Kei

机构信息

Department of Dermatology, JR Sapporo Hospital, Sapporo, JPN.

出版信息

Cureus. 2024 Nov 11;16(11):e73485. doi: 10.7759/cureus.73485. eCollection 2024 Nov.

DOI:10.7759/cureus.73485
PMID:39669836
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11635038/
Abstract

Bullous pemphigoid (BP) is a chronic autoimmune disorder characterized by subepidermal blister formation, primarily affecting elderly individuals. While BP has been associated with malignancies, the exact nature of this relationship remains unclear. We report the case of a 72-year-old man who presented with pruritic cutaneous lesions, including tense vesicles and bullae and was diagnosed with BP. Despite treatment with doxycycline, nicotinamide, and topical clobetasol, his symptoms persisted. A routine chest X-ray, conducted as part of his diagnostic workup, incidentally, revealed a large mass in the right upper lung, which was subsequently diagnosed as squamous cell carcinoma. Remarkably, after the surgical resection of the tumor, the patient's BP lesions completely resolved within seven weeks, without alterations to his dermatologic treatment. This case emphasizes the importance of malignancy screening in patients with persistent BP and suggests a possible link between BP and underlying cancer, particularly when standard therapies prove ineffective. Further investigation into the mechanisms connecting these conditions is warranted.

摘要

大疱性类天疱疮(BP)是一种慢性自身免疫性疾病,其特征为表皮下疱形成,主要影响老年人。虽然BP与恶性肿瘤有关,但这种关系的确切性质仍不清楚。我们报告一例72岁男性患者,其出现瘙痒性皮肤损害,包括紧张性水疱和大疱,被诊断为BP。尽管用强力霉素、烟酰胺和外用氯倍他索治疗,其症状仍持续存在。作为其诊断检查的一部分进行的常规胸部X线检查偶然发现右上肺有一个大肿块,随后被诊断为鳞状细胞癌。值得注意的是,肿瘤手术切除后,患者的BP损害在7周内完全消退,其皮肤科治疗未改变。该病例强调了对持续性BP患者进行恶性肿瘤筛查的重要性,并提示BP与潜在癌症之间可能存在联系,特别是在标准治疗无效时。有必要进一步研究连接这些情况的机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/0342815528c0/cureus-0016-00000073485-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/f777317930d0/cureus-0016-00000073485-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/724df1418ab3/cureus-0016-00000073485-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/58a0356305bb/cureus-0016-00000073485-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/ab50a59bd3cc/cureus-0016-00000073485-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/fa97a65a1641/cureus-0016-00000073485-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/6cf1a83faebd/cureus-0016-00000073485-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/0342815528c0/cureus-0016-00000073485-i07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/f777317930d0/cureus-0016-00000073485-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/724df1418ab3/cureus-0016-00000073485-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/58a0356305bb/cureus-0016-00000073485-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/ab50a59bd3cc/cureus-0016-00000073485-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/fa97a65a1641/cureus-0016-00000073485-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/6cf1a83faebd/cureus-0016-00000073485-i06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/127f/11635038/0342815528c0/cureus-0016-00000073485-i07.jpg

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本文引用的文献

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Front Immunol. 2024 Aug 29;15:1416473. doi: 10.3389/fimmu.2024.1416473. eCollection 2024.
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Prevalence, Spectrum and Clinical Implications of Malignancies in Patients with Bullous Pemphigoid.
大疱性类天疱疮患者的恶性肿瘤的患病率、谱及临床意义。
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Bullous pemphigoid associated with squamous cell lung carcinoma showing remarkable response to carboplatin-based chemotherapy:  a case report.大疱性类天疱疮伴鳞状细胞肺癌,对含卡铂的化疗有显著反应:病例报告。
J Med Case Rep. 2022 May 5;16(1):184. doi: 10.1186/s13256-022-03323-9.
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The Role of Collagen XVII in Cancer: Squamous Cell Carcinoma and Beyond.XVII型胶原蛋白在癌症中的作用:鳞状细胞癌及其他
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