Bullous pemphigoid and radiotherapy: case report and literature review update
https://doi.org/10.4081/dr.2022.9170
Accepted: 14 September 2021
HTML: 6
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
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.
Bernard P, Antonicelli F. Bullous Pemphigoid: A Review of its Diagnosis, Associations and Treatment. Am J Clin Dermatol 2017;18:513–28. DOI: https://doi.org/10.1007/s40257-017-0264-2
Schmidt E, Zillikens D. Pemphigoid diseases. Lancet 2013;381:320–32. DOI: https://doi.org/10.1016/S0140-6736(12)61140-4
Miyamoto D, Santi CG, Aoki V, Maruta CW. Bullous pemphigoid. An Bras Dermatol 2019;94:133–46. DOI: https://doi.org/10.1590/abd1806-4841.20199007
Binitha MP, Vishnu VV, Sreekanth S, Reena Mariyath OK. Localized bullous pemphigoid on sites of radiotherapy and lymphedema in the same patient. Indian Dermatol Online J 2014;5:S101-3. DOI: https://doi.org/10.4103/2229-5178.146170
Trombetta M, Erb K, Kudithipudi V, Small J. Bullous pemphigoid appearing as superficial tissue necrosis after irradiation of the breast: Case history and definitive review of the literature. J Solid Tumors 2015;5. DOI: https://doi.org/10.5430/jst.v5n2p53
Nieder C, Al-Shibli K, Tollåli T. Nontargeted Effect after Radiotherapy in a Patient with Non-Small Cell Lung Cancer and Bullous Pemphigoid. Case Rep Oncol Med 2015;2015:964687. DOI: https://doi.org/10.1155/2015/964687
Rejeb M, Moujahed R, Zehani A, Kochbati L. Bullous pemphigoid development during the course of breast cancer: a radiation induced or a radiation recall dermatitis? J Radiother Pract 2020:1-3.
Duschet P, Schwarz T, Gschnait F. Bullous pemphigoid after radiation therapy. J Am Acad Dermatol 1988;18:441-4. DOI: https://doi.org/10.1016/S0190-9622(88)70066-3
Nguyen T, Kwan JM, Ahmed AR. Relationship between radiation therapy and bullous pemphigoid. Dermatology 2014;229:88-96. DOI: https://doi.org/10.1159/000362208
Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009 Jul 21;339:b2535. DOI: https://doi.org/10.1136/bmj.b2535
Campa M, Mansouri B, Wilcox B, Griffin JR. Radiation-induced localized bullous pemphigoid in a patient with breast carcinoma. Dermatol Online J 2016;22. DOI: https://doi.org/10.5070/D3221029800
Shon W, Wada DA, Kalaaji AN. Radiation-induced pemphigus or pemphigoid disease in 3 patients with distinct underlying malignancies. Cutis 2016;97:219-22.
Kluger N, Mandelin J, Santti K, et al. Bullous pemphigoid triggered by radiotherapy for breast cancer. Presse Med 2017;46:128-30. DOI: https://doi.org/10.1016/j.lpm.2016.09.019
Hirotsu K, Chiou AS, Chiang A, et al. Localized bullous pemphigoid in a melanoma patient with dual exposure to PD-1 checkpoint inhibition and radiation therapy. JAAD Case Rep 2017;3:404-6. DOI: https://doi.org/10.1016/j.jdcr.2017.06.004
Tanita K, Fujimura T, Kambayashi Y, et al. Intensity-Modulated Radiotherapy Triggers Onset of Bullous Pemphigoid in a Patient with Advanced Melanoma Treated with Nivolumab. Case Rep Oncol 2018;11:114-8. DOI: https://doi.org/10.1159/000487127
Grimaux X, Delva R, Jadaud E, Croue A. Nivolumab-induced bullous pemphigoid after radiotherapy and abscopal effect. Australas J Dermatol 2019;60:e235-6. DOI: https://doi.org/10.1111/ajd.12987
Hung T-L, Chen Y-L, Lin K-T, et al. Risk of radiotherapy-associated autoimmune bullous disease among Taiwanese patients with breast cancer: a case-control study. Arch Dermatol Res 2020;312:69-75. DOI: https://doi.org/10.1007/s00403-019-01985-y
Kim J, Jung T, Kim K, et al. Radiation induced pemphigoid disease. Obstet Gynecol Sci 2020;63:750-2. DOI: https://doi.org/10.5468/ogs.20088
Palleschi GM, Pietro MD, Barzacchi M, et al. A case of laryngeal mucous membrane pemphigoid possibly triggered by radiotherapy. Indian J Dermatol 2020;65:546. DOI: https://doi.org/10.4103/ijd.IJD_163_19
Ashack KA, Kuritza V, Visconti MJ, Ashack L. Dermatologic Sequelae Associated with Radiation Therapy. Am J Clin Dermatol 2020;21:541-55. DOI: https://doi.org/10.1007/s40257-020-00519-x
Mul VEM, van Geest AJ, Pijls- Johannesma MCG, et al. Radiationinduced bullous pemphigoid: a systematic review of an unusual radiation side effect. Radiother Oncol 2007;82:5-9. DOI: https://doi.org/10.1016/j.radonc.2006.11.014
PAGEPress has chosen to apply the Creative Commons Attribution NonCommercial 4.0 International License (CC BY-NC 4.0) to all manuscripts to be published.
Downloads
Citations
