Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case ReportCorrespondence Address :
Dr. Sadaksharam Jayachandran,
Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital,
Tamil Nadu Dr. M.G.R Medical University, Chennai-600032, Tamil Nadu, India.
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.
Immunobullous disorders, Immunomodulators, Lymphoproliferative neoplasms, Squamous cell carcinoma
Sadaksharam Jayachandran, M Preethi. MULTIDISCIPLINARY CLINICAL MANAGEMENT OF PARANEOPLASTIC PEMPHIGUS – A CASE REPORT. Journal of Clinical and Diagnostic Research [serial online] 2017 October [cited: 2017 Oct 24 ]; 11:ZD01-ZD03. Available from
Date of Submission: Apr 09, 2017
Date of Peer Review: Jun 06, 2017
Date of Acceptance: Jul 17, 2017
Date of Publishing: Oct 01, 2017
FINANCIAL OR OTHER COMPETING INTERESTS: None.
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