Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

Users Online : 27768

Case report
Year : 2017 | Month : October | Volume : 11 | Issue : 10 | Page : ZD01 - ZD03

Multidisciplinary Clinical Management of Paraneoplastic Pemphigus – A Case Report

Sadaksharam Jayachandran, M Preethi

1. Professor and Head, Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital, Tamil Nadu Dr. M.G.R Medical University, Chennai, Tamil Nadu, India. 2. Postgraduate Student, Department of Oral Medicine and Radiology, Tamil Nadu Government Dental College and Hospital, Tamil Nadu Dr. M.G.R Medical University, Chennai, Tamil Nadu, India.

Correspondence 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.
E-mail: drsjayachandranmds@yahoo.com

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.

Keywords

Immunobullous disorders, Immunomodulators, Lymphoproliferative neoplasms, Squamous cell carcinoma

How to cite this article :

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
http://jcdr.net/back_issues.asp?issn=0973-709x&year=2017&month=October&volume=11&issue=10&page=ZD01-ZD03&id=10708

DOI and Others

DOI: 10.7860/JCDR/2017/29160.10708

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.

JCDR is now Monthly and more widely Indexed .
  • PubMed Central® (PMC)New
  • Academic Search Complete Database
  • Chemical Abstracts Service
  • Directory of Open Access Journals (DOAJ)
  • EBSCOhostNew
  • Embase & EMbiology
  • Google Scholar
  • HINARI Access to Research in Health Programme
  • Indian Science Abstracts (ISA)
  • Journal seek Database
  • Open J-Gate
  • Popline (reproductive health literature)
  • SCOPUS
  • www.omnimedicalsearch.com