Bullous pemphigoid development during the course of breast cancer: a radiation induced or a radiation recall dermatitis?

Abstract

Background: Bullous pemphigoid (BP) is the most common autoimmune bullous disease, which is usually seen in older ages. Rarely, radiotherapy (RT) has been reported as a localised trigger factor for BP. Case: We present a case of a 64-year-old woman who underwent radical mastectomy and radiation therapy for breast cancer. Two months after the completion of RT with adjuvant Trastuzumab, a BP eruption developed in the irradiated area, spreading thereafter to other skin areas. The patient was treated with oral corticosteroids and the lesions evolved favourably. Conclusion: This case demonstrates a relatively benign skin reaction that could develop during the course of cancer treatment, which required co-management by oncologists, pathologists and dermatologists.

Bullous pemphigoid and radiotherapy: case report and literature review update

“…A total of 13 residual articles fulfilling the inclusion criteria were included in the present review update. Table 1 summarizes the main characteristics of the selected studies (4)(5)(6)(7)(11)(12)(13)(14)(15)(16)(17)(18)(19). Eleven articles are case reports (4)(5)(6)(7)11,(13)(14)(15)(16)18,19), while a case series of 2 patients was provided by Shon et al (12).…”

“…Table 1 summarizes the main characteristics of the selected studies (4)(5)(6)(7)(11)(12)(13)(14)(15)(16)(17)(18)(19). Eleven articles are case reports (4)(5)(6)(7)11,(13)(14)(15)(16)18,19), while a case series of 2 patients was provided by Shon et al (12). Hung et al (17), reported the first large-scale case-control study in 2019, focusing on the relationship between the development of autoimmune blistering disease among patients mainly affected by breast cancer and treated with RT.…”

“…They can be either localized or widespread, while the involvement of the mucosae is reported in 10-30% of cases with oral, esophageal and genital lesions (3). Besides the aforementioned possible causes, several case reports suggest a potential role of radiotherapy (RT) as BP trigger for disease onset or recrudescence (4)(5)(6)(7). The first report of a RT-associated localized BP was documented by Duschet et al in 1988 (8) and the most recent review of PB cases linked to RT dates back to 2014, describing a total of 29 known cases (9).…”