Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 10
Abstract
Paraneoplastic pemphigus is a rare immunobullous disorder commonly associated with lymphoproliferative neoplasms and less commonly in carcinomas with a poor prognosis. The neoplasms produce autoantibodies that react with members of plakin family to produce a suprabasilar split and varied clinical presentations in the skin and mucous membrane. Oral erosions are the first manifestation most resistant to treatment and persist even after the underlying tumour has been resected or treated. We report here a rare case of paraneoplastic pemphigus with an underlying squamous cell carcinoma of the oesophagus that constitutes only 8% of the neoplasms associated with this condition. It was successfully managed by a multidisciplinary approach involving the Departments of Dermatology, Surgical Oncology and Oral Medicine. The oral erosions were resistant to treatment however, a patient-tailored treatment was advocated using professionally administered debridement with hydrogen peroxide diluted with hypotonic saline, high potency topical steroids, analgesic oral rinses and topical anaesthetics with systemically administered immunomodulators. Hence, management of such cases exhibiting systemic and oral manifestations require a multidisciplinary team approach to improve the quality of life of the patients.
Authors and Affiliations
sadaksharam jayachandran, M preethi
Keywords
Related Articles
- EP ID EP365887
- DOI 10.7860/JCDR/2017/29160.10708
- Views 107
- Downloads 0
Cheyne Stokes Breathing in a Case of Tubercular Meningitis with Hydrocephalus
Images in Medicine
Prevalence of Conventional Risk Factors and Evaluation of Baseline Indices Among Young and Elderly Patients with Coronary Artery Disease
Introduction: Coronary Artery Disease (CAD) is a leading cause of morbidity and mortality worldwide, manifesting in a variety of clinical spectrums such as an asymptomatic disease or acute coronary syndrome. It has becom...
Screening of Pregnant Women for Anti-Toxoplasma Antibodies and their Newborn for Vertical Transmission
Introduction: Toxoplasmosis is a world-wide protozoanzoonosis caused by Toxoplasma gondii (T. gondii). Primary infections during pregnancy may result in miscarriages, still births, and congenital malformations in the new...
A Study of Tear Ferning Patterns in Elderly Individuals with Dry Eye Disorder
ABSTRACT Introduction: Anomalies of the mucin layer of the tear film have generally been studied in relation to contact lens users who represent a young population. Since the prevalence of dry eye increases with age and...
Expression of Oct4 Protein in Astrocytic Tumours-Histopathologic and Immunohistochemical Study
ABSTRACT Introduction: The majority of gliomas in adults are resistant to therapy. Therapy resistance has been attributed to the presence of cancer stem cells (CSCs). Oct4 is a transcription factor required for maintaini...