Paraneoplastic pemphigus: a rare case

Paraneoplastic pemphigus is an autoimmune disorder characterized by recalcitrant blistering, erosive mucocutaneous lesions, associated neoplasm and high titres of “pemphigus-like” anti-cell surface autoantibodies. A 55-years-old male presented to the OPD with fluid filled lesions over the chin region and few crusted lesions over the chin and chest since 10 days. There was a history of carcinoma tongue 6months back for which patient underwent 33 sessions of radiotherapy and chemotherapy. Various investigations, including hemogram, serum biochemistry, thyroid profile, lipid profile, viral markers, serum electrophoresis and histopathological examination, were conducted. Histopathology showed intraepidermal blister formation and DIF showed immune deposits in a linear deposition at DEJ and in a fishnet pattern over keratinised surface. Based on history and thorough examination, the case was diagnosed as Paraneoplastic Pemphigus. Patient was treated with oral corticosteroids, oral and topical antibiotics and complete resolution of all skin lesions and with residual pigmentary changes was seen after 4 weeks.