In pemphigoid disease, the serum levels of ECP seem to be correlated with the activated secreting and tissue-damaging eosinophils found in the dermis, supporting the concept of an active participation of eosinophils in generating cutaneous lesions.
Sir,No unanimous assent has been reached yet on the de nition of cutaneous paraneoplasti c syndromes, but judging from the literature, it seems clear that at least three essential criteria must be satis ed (1): rst, the dermatosis must arise after the development of malignant tumor (although cutaneous manifestations may or may not precede its diagnosis); second, both the dermatosis and the malignancy should follow a parallel course; third, the dermatosis must be uncommon, in order to exclude a casual association.In accordance with these guidelines, we describe the case of a 57-year-old man with pulmonary squamous cell carcinoma who developed a bullous eruption with Fig. 1. Erythemato-in ltrated plaques and vesico-bullae located on clinical features of dermatitis herpetiformis and an the back.immunopathological pro le of pemphigus. Since the appearance of the disease and its evolution were on a strictly parallel neoplastic course, a diagnosis of paraimmuno uorescence (DIF ) showed an intraepidermal neoplastic pemphigus herpetiformis was proposed. The deposition of IgG and C3. Immunoblot assay demonrarity of this clinical presentation and the opportunity strated autoantibodies against 150 and 230 kDa antigens to include our case in the broad spectrum of parathat bound to the epidermal side of normal split skin. neoplastic pemphigus (PNP), as it is classically de ned, Histological examination of lesional skin of the back are also discussed.disclosed mild eosinophilic spongiosis in the epidermis and mononuclear in ltration of the upper dermis with neutrophils and eosinophils when the erythemato-CASE REPORT in ltrated urticarial plaque was biopsied; in contrast, at the periphery of the lesions, intraepidermal acantholysis A 57-year-old man presented for evaluation and treatment of a bullous dermatosis of 2-months' duration. A and suprabasal detachment could be seen, vesico-bullae containing acantholytic cells, eosinophils and brin. family history of lung carcinoma (in a brother) was signi cant and the patient was taking fenitoine for a When a routine chest X-ray was performed, a 5-cm cavitated mass was detected in the left upper lung zone. post-treatment complication of a previous intracranial aneurysm.A CT scan showed both direct extension to the scissural and parietal pleura and enlargement of the ipsilateral At the time of our observation, erythemato-in ltrated urticarial lesions with annular or otherwise gurate hilar nodes. Mucosal biopsy of the lung using bronchoscopy revealed squamous cell carcinoma, histologically. borders were seen on the anterior chest and back of the patient (Fig. 1). Tense serous vesicles were superimposed An abdominal and cranium CT failed to detect metastatic spreading of the neoplasm. on the plaques peripherally together, with linear crusts caused by persistent rubbing. On the proximal aspects Based on the clinical, histological and immunopathological ndings, a diagnosis of paraneoplastic pemphigus of the thighs and the exor surfaces of the arms similar lesions, without a tendency to bli...
The authors describe two cases of tinea capitis in adults, one due to Microsporum canis and the other to Trichophyton rubrum. The atypical clinical presentation of the dermatophytosis in these two cases is stressed. It is hypothesized that in both cases the disease spread from primary lesion on the face.
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