Pemphigus vulgaris presenting in a radiation portal. J Am Acad Dermatol 2007 May;56(5 Suppl):S82-5
Date
04/17/2007Pubmed ID
17434046DOI
10.1016/j.jaad.2006.10.956Scopus ID
2-s2.0-34047254510 (requires institutional sign-in at Scopus site) 26 CitationsAbstract
We report a case of mucocutaneous pemphigus vulgaris in a patient with squamous cell carcinoma of the lung. The cutaneous involvement was limited to the skin within his therapeutic radiation portal. The diagnosis of pemphigus vulgaris was confirmed by histopathology and immunologic studies. Direct immunofluorescence demonstrated IgG and C3 in the intercellular spaces and indirect immunofluorescence was positive on monkey esophagus at a titer of 1:160. Enzyme-linked immunosorbent assay of the patient's serum detected autoantibodies only to desmoglein (Dsg)3, with no reactivity to Dsg1. Immunomapping of perilesional skin from the irradiated field illustrated decreased Dsg1 expression compared with a control sample from an area that was not exposed to radiation. This case provides support for the Dsg compensation hypothesis and may also suggest a mechanism by which irradiation may induce skin lesions.
Author List
Robbins AC, Lazarova Z, Janson MM, Fairley JAMESH terms used to index this publication - Major topics in bold
AutoantibodiesCarcinoma, Squamous Cell
Complement C3
Desmoglein 1
Desmoglein 2
Enzyme-Linked Immunosorbent Assay
Epidermis
Extracellular Space
Fluorescent Antibody Technique, Direct
Fluorescent Antibody Technique, Indirect
Humans
Immunoglobulin G
Lung Neoplasms
Male
Middle Aged
Pemphigus
Radiation Injuries
Skin
