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Case for diagnosis. Radiotherapy-induced pemphigus vegetans
Hiram Larangeira de Almeida1, Antônia Larangeira de Almeida2, Pedro Henrique Evangelista Martinez2
1Pós-Graduação em Saúde e Comportamento, Universidade Católica de Pelotas, Departamento de Dermatologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil.
Anais Brasileiros De Dermatologia
|March 18, 2022
Summary
A patient developed radiotherapy-induced pemphigus vegetans after anal cancer treatment. This rare condition presented as painful skin erosion and responded well to corticosteroid therapy.
Area of Science:
- Dermatology
- Oncology
Background:
- Squamous cell carcinoma of the anal canal is a rare malignancy.
- Chemoradiotherapy, including 5-fluorouracil, cisplatin, and radiation, is a standard treatment for anal cancer.
- Complete remission is often achieved with chemoradiotherapy.
Observation:
- A 73-year-old male patient presented with painful perianal and intergluteal erosion with pustular borders 45 days after completing chemoradiotherapy for anal squamous cell carcinoma.
- Histopathological examination revealed pseudoepitheliomatous hyperplasia, microabscesses, and acantholytic keratinocytes.
- Indirect immunofluorescence showed a positive IgG intercellular pattern at a 1:80 titer.
Findings:
- The patient was diagnosed with radiotherapy-induced pemphigus vegetans.
- The condition showed significant regression with oral prednisone and topical betamethasone treatment.
Implications:
- Radiotherapy-induced pemphigus vegetans is a rare but treatable adverse effect of cancer therapy.
- Early diagnosis and appropriate management with corticosteroids are crucial for patient outcomes.
- This case highlights the importance of recognizing paraneoplastic or treatment-related dermatological conditions in cancer patients.
