Document Detail


Paraneoplastic pemphigus treated with dexamethasone/ cyclophosphamide pulse therapy.
MedLine Citation:
PMID:  9889426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Paraneoplastic pemphigus (PNP) is an autoimmune, mucocutaneous bullous disease associated with underlying malignancies. We report a patient with Waldenström's macroglobulinemia who developed clinical, histological and immunopathological features typical of PNP. The patient was treated twice with i.v. dexamethasone and cyclophosphamide pulse therapy (day 1: cyclophosphamide 500 mg i.v.; day 1-3: dexamethasone 100 mg i.v.) at 3-week intervals. Therapy was continued with oral cyclophosphamide (50 mg/d). Two weeks after initiation of treatment, significant improvement of the cutaneous and mucosal lesions was noted. The therapy also had beneficial effects on the macroglobulinemia in terms of a marked reduction of the IgM lambda serum level. Three months after the second pulse, severe stomatitis recurred but the patient rejected any further systemic therapy. The initial response of the usually recalcitrant mucosal and skin lesions of PNP makes dexamethasone/cyclophosphamide pulse therapy an interesting therapeutic option.
Authors:
L R Becker; B C Bastian; U Wesselmann; S Karl; H Hamm; E B Bröcker
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  European journal of dermatology : EJD     Volume:  8     ISSN:  1167-1122     ISO Abbreviation:  Eur J Dermatol     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-02-18     Completed Date:  1999-02-18     Revised Date:  2006-04-24    
Medline Journal Info:
Nlm Unique ID:  9206420     Medline TA:  Eur J Dermatol     Country:  FRANCE    
Other Details:
Languages:  eng     Pagination:  551-3     Citation Subset:  IM    
Affiliation:
Department of Dermatology, University of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany. becker-lr@mail.uni-wuerzberg.de
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Aged
Aged, 80 and over
Antineoplastic Agents, Alkylating / administration & dosage
Antineoplastic Agents, Hormonal / administration & dosage
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
Cyclophosphamide / administration & dosage
Dexamethasone / administration & dosage
Drug Administration Schedule
Follow-Up Studies
Humans
Injections, Intravenous
Male
Paraneoplastic Syndromes / diagnosis,  drug therapy*,  etiology
Pemphigus / diagnosis,  drug therapy*,  etiology
Treatment Outcome
Waldenstrom Macroglobulinemia / complications
Chemical
Reg. No./Substance:
0/Antineoplastic Agents, Alkylating; 0/Antineoplastic Agents, Hormonal; 50-02-2/Dexamethasone; 50-18-0/Cyclophosphamide

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