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- Title
Bullous pemphigoid and radiotherapy: Case report and literature review update.
- Authors
Piras, Antonio; Fionda, Bruno; Sanfratello, Antonella; D'Aviero, Andrea; Sortino, Giovanni; Pernice, Gianfranco; Boldrini, Luca; Angileri, Tommaso; Daidone, Antonino
- Abstract
Bullous pemphigoid (BP) is a common autoimmune bullous disease generally occurring in elderly patients. Itchy and tense blisters on normal skin or erythematous and edematous lesions on the trunk and extremities usually characterize BP. Trigger factors are still unclear while several case reports suggest a potential role of radiotherapy (RT) as BP trigger for disease onset or recrudescence. A review was performed to provide an update of literature. A case report of a patient affected by BP undergoing two radiotherapy courses for a primary breast cancer was also reported. A comprehensive review of the published literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review included studies describing BP and its relationships with RT treatments. A total of 13 articles were reviewed. Studies characteristics analysis resulted in eleven case reports, one case series and one large-scale case-control study. Literature update confirms the existence of a reasonable connection between RT and BP. Case report showed that a multidisciplinary management seems to assure the feasibility of RT in patients affected by BP, not depriving them of standard therapeutic opportunities. Introduction Bullous pemphigoid (BP) is the most common autoimmune bullous disease and generally occurs in elderly patients.1 The underlying pathophysiological mechanism is based on the presence of autoantibodies that recognize self-antigens at the level of the basement membrane, responsible for the adhesion between the epidermis and the dermis. Its trigger factors are still unclear and different conditions, such as psoriasis, lichen planus and drugs, may be involved in the pathogenesis.2 This condition usually affects elderly individuals and is often characterized by itchy and tense blisters on normal skin or erythematous and edematous lesions on the trunk and extremities.3 Disease localizations primarily affect the axillary folds, lower abdomen, groin areas and inner thighs. They can be either localized or widespread, while the involvement of the mucosae is reported in 10-30% of cases with oral, esophageal and genital lesions.3 Besides the aforementioned possible causes, several case reports suggest a potential role of radiotherapy (RT) as BP trigger for disease onset or recrudescence.4-7 The first report of a RT-associated localized BP was documented by Duschet et al.8 in 1988 and the most recent review of PB cases linked to RT dates back to 2014, describing a total of 29 known cases.9 Aim of this paper is to provide an update of the available literature and to report the case of a patient affected by BP undergoing two radiotherapy courses for a primary breast cancer.
- Subjects
BULLOUS pemphigoid; OLDER people; OLDER patients; LICHEN planus; DISEASE relapse
- Publication
Dermatology Reports, 2022, Vol 14, Issue 2, p3
- ISSN
2036-7406
- Publication type
Case Study