Skip to main content
Top
Published in: Journal of Medical Case Reports 1/2022

Open Access 01-12-2022 | Lung Cancer | Case report

Bullous pemphigoid associated with squamous cell lung carcinoma showing remarkable response to carboplatin-based chemotherapy:  a case report

Authors: Prajwol Shrestha, Mathew K. George, Sweta Baidya, Sunil K. Rai

Published in: Journal of Medical Case Reports | Issue 1/2022

Login to get access

Abstract

Background

Bullous pemphigoid is an uncommon dermatologic manifestation seen in squamous cell lung cancer, and evidence guiding optimal treatment, especially in the elderly population, is limited. We report herein a case of squamous cell lung cancer diagnosed after being investigated for refractory bullous pemphigoid showing marked response to carboplatin-based chemotherapy. This is the first case report that shows carboplatin can be used as an effective alternative in treatment of malignancy-associated bullous pemphigoid.

Case report

An 80-year-old caucasian man developed extensive vesiculobullous rashes on his trunk, chest, abdomen, and inguinal region associated with significant pruritus causing sleep disturbance. The diagnosis of bullous pemphigoid was confirmed on skin biopsy. The skin lesions continued to worsen even after use of oral and topical steroid in addition to oral doxycycline. Chest computed tomography revealed a spiculated left lung lesion along with mediastinal lymphadenopathy. Fine-needle aspiration from the mediastinal lymph node confirmed metastatic squamous cell lung carcinoma. Carboplatin with gemcitabine was initiated, and significant response was seen within 3 days of chemotherapy. The skin lesions continued to remain in remission even after stopping the chemotherapy.

Conclusion

Although there are still controversies regarding paraneoplastic etiology of bullous pemphigoid, this case presents a temporal association. It is the first case report showing a remarkable response with the use of a carboplatin-based regimen.
Literature
1.
go back to reference Cakmak O, Seçkin D, Ceken I, Yilmaz I, Akkuzu B, Ozluoglu L. Bullous pemphigoid associated with parotid carcinoma. Otolaryngol Head Neck Surg. 2002;127(4):354–6.CrossRef Cakmak O, Seçkin D, Ceken I, Yilmaz I, Akkuzu B, Ozluoglu L. Bullous pemphigoid associated with parotid carcinoma. Otolaryngol Head Neck Surg. 2002;127(4):354–6.CrossRef
2.
go back to reference Robinson ND, Hashimoto T, Amagai M, Chan LS. The new pemphigus variants. J Am Acad Dermatol. 1999;40(5):649–71.CrossRef Robinson ND, Hashimoto T, Amagai M, Chan LS. The new pemphigus variants. J Am Acad Dermatol. 1999;40(5):649–71.CrossRef
3.
go back to reference Robak E, Robak T. Skin lesions in chronic lymphocytic leukaemia. Leuk Lymphoma. 2007;48(5):855–65.CrossRef Robak E, Robak T. Skin lesions in chronic lymphocytic leukaemia. Leuk Lymphoma. 2007;48(5):855–65.CrossRef
4.
go back to reference Pelosof LC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc. 2010;85(9):838–54.CrossRef Pelosof LC, Gerber DE. Paraneoplastic syndromes: an approach to diagnosis and treatment. Mayo Clin Proc. 2010;85(9):838–54.CrossRef
5.
go back to reference Chung VQ, Moschella SL, Zembowicz A, Liu V. Clinical and pathologic findings of paraneoplastic dermatoses. J Am Acad Dermatol. 2006;54:745.CrossRef Chung VQ, Moschella SL, Zembowicz A, Liu V. Clinical and pathologic findings of paraneoplastic dermatoses. J Am Acad Dermatol. 2006;54:745.CrossRef
6.
go back to reference Takeuchi M, Okazaki A, Nakajima N, Saito Y, Nozaki M, Niibe H. A case of Lung cancer with bullous pemphigoid. Gan No Rinsho. 1986;32(5):529–33.PubMed Takeuchi M, Okazaki A, Nakajima N, Saito Y, Nozaki M, Niibe H. A case of Lung cancer with bullous pemphigoid. Gan No Rinsho. 1986;32(5):529–33.PubMed
7.
go back to reference Sato Y, Endo K, Ishikawa S, Onizuka M, Mitsui K, Mitsui T. A case of resected lung cancer associated with bullous pemphigoid. Nihon Kyobu Geka Gakkai Zasshi. 1996;44(4):524–8.PubMed Sato Y, Endo K, Ishikawa S, Onizuka M, Mitsui K, Mitsui T. A case of resected lung cancer associated with bullous pemphigoid. Nihon Kyobu Geka Gakkai Zasshi. 1996;44(4):524–8.PubMed
8.
go back to reference Balestri R, La Placa MMM, et al. Malignancies in bullous pemphigoid: a controversial association. J Dermatol. 2015;43:125–33.CrossRef Balestri R, La Placa MMM, et al. Malignancies in bullous pemphigoid: a controversial association. J Dermatol. 2015;43:125–33.CrossRef
9.
go back to reference Försti AK, Jokelainen J, Timonen M, Tasanen K. Increasing incidence of bullous pemphigoid in Northern Finland: a retrospective database study in Oulu University Hospital. Br J Dermatol. 2014;171(5):1223.CrossRef Försti AK, Jokelainen J, Timonen M, Tasanen K. Increasing incidence of bullous pemphigoid in Northern Finland: a retrospective database study in Oulu University Hospital. Br J Dermatol. 2014;171(5):1223.CrossRef
10.
go back to reference Brick KE, Weaver CH, Lohse CM, Pittelkow MR. Incidence of bullous pemphigoid and mortality of patients with bullous pemphigoid in Olmsted County, Minnesota, 1960 through 2009. J Am Acad Dermatol. 2014;71(1):92–9 (Epub 2014 03rd April).CrossRef Brick KE, Weaver CH, Lohse CM, Pittelkow MR. Incidence of bullous pemphigoid and mortality of patients with bullous pemphigoid in Olmsted County, Minnesota, 1960 through 2009. J Am Acad Dermatol. 2014;71(1):92–9 (Epub 2014 03rd April).CrossRef
11.
go back to reference Joly P, Baricault S, Sparsa A. Incidence and mortality of bullous pemphigoid in France. J Invest Dermatol. 2012;132(8):1998.CrossRef Joly P, Baricault S, Sparsa A. Incidence and mortality of bullous pemphigoid in France. J Invest Dermatol. 2012;132(8):1998.CrossRef
12.
go back to reference Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2018. http://www.healthdata.org/gbd. Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2017 (GBD 2017) Results. Seattle, United States: Institute for Health Metrics and Evaluation (IHME), 2018. http://​www.​healthdata.​org/​gbd.
13.
go back to reference Ogawa H, Sakuma M, Morioka S, Kitamura K, Sasai Y, Imamura S, Inaba Y. The incidence of internal malignancies in pemphigus and bullous pemphigoid in Japan. J Dermatol Sci. 1995;9(2):136–41.CrossRef Ogawa H, Sakuma M, Morioka S, Kitamura K, Sasai Y, Imamura S, Inaba Y. The incidence of internal malignancies in pemphigus and bullous pemphigoid in Japan. J Dermatol Sci. 1995;9(2):136–41.CrossRef
14.
go back to reference Chang YT, Liu HN, Wong CK. Bullous pemphigoid—a report of 86 cases from Taiwan. Clin Exp Dermatol. 1996;21(1):20–2.CrossRef Chang YT, Liu HN, Wong CK. Bullous pemphigoid—a report of 86 cases from Taiwan. Clin Exp Dermatol. 1996;21(1):20–2.CrossRef
15.
go back to reference Lindelöf B, Islam N, Eklund G, Arfors L. Pemphigoid and cancer. Arch Dermatol. 1990;126(1):66–8.CrossRef Lindelöf B, Islam N, Eklund G, Arfors L. Pemphigoid and cancer. Arch Dermatol. 1990;126(1):66–8.CrossRef
16.
go back to reference Stone SP, Schroeter AL. Bullous pemphigoid and associated malignant neoplasms. Arch Dermatol. 1975;111(8):991–4.CrossRef Stone SP, Schroeter AL. Bullous pemphigoid and associated malignant neoplasms. Arch Dermatol. 1975;111(8):991–4.CrossRef
17.
go back to reference Rook AJ. A pemphigoid eruption associated with carcinoma of the bronchus. Trans St Johns Hosp Dermatol Soc. 1968;54:152–4.PubMed Rook AJ. A pemphigoid eruption associated with carcinoma of the bronchus. Trans St Johns Hosp Dermatol Soc. 1968;54:152–4.PubMed
18.
go back to reference Graham-Brown RA. Bullous pemphigoid with figurate erythema associated with carcinoma of the bronchus. Br J Dermatol. 1987;117(3):385–8.CrossRef Graham-Brown RA. Bullous pemphigoid with figurate erythema associated with carcinoma of the bronchus. Br J Dermatol. 1987;117(3):385–8.CrossRef
19.
go back to reference Shigemori M, Yoshida S, Azai S, Fujii K, Azuma K, Nishikawa H, Otani Y, Inoue F, Furukawa H, Mizumoto T, Saiga T. An autopsied case of G-CSF producing lung cancer with bullous pemphigoid and hyper-gammaglobulinemia. Nippon Naika Gakkai Zasshi. 2001;90(10):2066–8.CrossRef Shigemori M, Yoshida S, Azai S, Fujii K, Azuma K, Nishikawa H, Otani Y, Inoue F, Furukawa H, Mizumoto T, Saiga T. An autopsied case of G-CSF producing lung cancer with bullous pemphigoid and hyper-gammaglobulinemia. Nippon Naika Gakkai Zasshi. 2001;90(10):2066–8.CrossRef
20.
go back to reference Lakhdar N, ElKhattabi W, Lahroussi M, Afif H, Aichane A. Small cell lung cancer associated with paraneoplastic bullous pemphigoid. Rev Pneumol Clin. 2014;70(3):169–72.CrossRef Lakhdar N, ElKhattabi W, Lahroussi M, Afif H, Aichane A. Small cell lung cancer associated with paraneoplastic bullous pemphigoid. Rev Pneumol Clin. 2014;70(3):169–72.CrossRef
21.
go back to reference Janah H, Mahhou M, Souhi H, Zegmout A, Naji-Amrani H, Raoufi M, Elouazzani H, Rhorfi IA, Abid A. Pemphigoid bulleuse revelant un carcinome bronchique. Pan Afr Med J. 2014;19:45.PubMedPubMedCentral Janah H, Mahhou M, Souhi H, Zegmout A, Naji-Amrani H, Raoufi M, Elouazzani H, Rhorfi IA, Abid A. Pemphigoid bulleuse revelant un carcinome bronchique. Pan Afr Med J. 2014;19:45.PubMedPubMedCentral
22.
go back to reference Safini F, Tawfiq N. Paraneoplastic bullous pemphigoid associated with lung cancer. Pan Afr Med J. 2015;21:248.CrossRef Safini F, Tawfiq N. Paraneoplastic bullous pemphigoid associated with lung cancer. Pan Afr Med J. 2015;21:248.CrossRef
23.
go back to reference Das A, Das S, Das SK, Basuthakur S. A case of paraneoplastic bullous pemphigoid in association with squamous cell carcinoma of lung. J Postgrad Med. 2015;61(3):197–9.CrossRef Das A, Das S, Das SK, Basuthakur S. A case of paraneoplastic bullous pemphigoid in association with squamous cell carcinoma of lung. J Postgrad Med. 2015;61(3):197–9.CrossRef
Metadata
Title
Bullous pemphigoid associated with squamous cell lung carcinoma showing remarkable response to carboplatin-based chemotherapy:  a case report
Authors
Prajwol Shrestha
Mathew K. George
Sweta Baidya
Sunil K. Rai
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2022
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-022-03323-9

Other articles of this Issue 1/2022

Journal of Medical Case Reports 1/2022 Go to the issue