Abstract
Paraneoplastic pemphigus (PNP) is a debilitating and lethal adult and pediatric autoimmune blistering skin disease that occurs in the setting of a known or occult neoplasm. It is characterized by painful mucosal erosions that are often resistant to therapy. These clinical characteristics, in addition to positive immunohistochemistry findings make the diagnosis of PNP. The ability to recognize and diagnose PNP has dramatically improved in the last two and half decades. However, the mortality remains 75-90% with a mean survival of less than 1 year. The disease typically progresses from localized skin manifestations to multiple organ failure despite treatment with high dose corticosteroids and immunosuppressives. Because PNP has a low incidence and prevalence, information on treatment and management strategies has depended on a limited number of case reports and case series. The rarity of the disease hampers the ability to conduct large-scale clinical trials as well as investigations into the pathophysiology of PNP. In this article, we review clinical presentation, diagnosis, management, treatment, and pathophysiology of PNP.
Keywords: Autoantibodies, blistering disease, dermatology, desmoglein, paraneoplastic pemphigus, pemphigus.
Anti-Cancer Agents in Medicinal Chemistry
Title:Paraneoplastic Pemphigus: Autoimmune-Cancer Nexus in the Skin
Volume: 15 Issue: 10
Author(s): Animesh A. Sinha
Affiliation:
Keywords: Autoantibodies, blistering disease, dermatology, desmoglein, paraneoplastic pemphigus, pemphigus.
Abstract: Paraneoplastic pemphigus (PNP) is a debilitating and lethal adult and pediatric autoimmune blistering skin disease that occurs in the setting of a known or occult neoplasm. It is characterized by painful mucosal erosions that are often resistant to therapy. These clinical characteristics, in addition to positive immunohistochemistry findings make the diagnosis of PNP. The ability to recognize and diagnose PNP has dramatically improved in the last two and half decades. However, the mortality remains 75-90% with a mean survival of less than 1 year. The disease typically progresses from localized skin manifestations to multiple organ failure despite treatment with high dose corticosteroids and immunosuppressives. Because PNP has a low incidence and prevalence, information on treatment and management strategies has depended on a limited number of case reports and case series. The rarity of the disease hampers the ability to conduct large-scale clinical trials as well as investigations into the pathophysiology of PNP. In this article, we review clinical presentation, diagnosis, management, treatment, and pathophysiology of PNP.
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Cite this article as:
Sinha A. Animesh, Paraneoplastic Pemphigus: Autoimmune-Cancer Nexus in the Skin, Anti-Cancer Agents in Medicinal Chemistry 2015; 15 (10) . https://dx.doi.org/10.2174/1871520615666150716105425
DOI https://dx.doi.org/10.2174/1871520615666150716105425 |
Print ISSN 1871-5206 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5992 |
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