Paraneoplastic pemphigus in a patient with non-Hodgkin's lymphoma

Paraneoplastic pemphigus (PNP) is an autoimmune disorder occurring in the setting of an underlying neoplasm in which patients have polymorphous skin and mucous membrane lesions. We describe a patient with non-Hodgkin's lymphoma who developed bullous, ulcerating lesions in an area being treated with radiation therapy. The diagnosis of PNP was confirmed by indirect immunofluorescence of the patient's serum on rat bladder. The disorder was refractory to therapy, and ultimately the patient expired.