Lichenoid dermatitis in paraneoplastic pemphigus

A pathogenic trigger of epitope spreading?

Glen M. Bowen, Neill T. Peters, David P. Fivenson, Lyndon D. Su, Hossein C. Nousari, Grant James Anhalt, Kevin D. Cooper, Seth R. Stevens

Research output: Contribution to journalArticle

Abstract

Background: In select cases, lichen planus has been observed to be a paraneoplastic condition sometimes associated with paraneoplastic pemphigus, a disease featuring autoantibodies directed against plakin proteins, desmogleins 3 and 1, and a still uncharacterized 170-kd antigen. Epitope spreading describes the phenomenon where underlying chronic inflammation leads to the sequential recognition of new epitopes on self-proteins over time. Observations: Five of 6 patients diagnosed as having paraneoplastic pemphigus had concomitant clinical and histological features of lichen planus. In 1 patient, results of the initial indirect immunofluorescence on rat bladder were negative and only 2 of the 5 antigens were identified by immunoprecipitation. After 1 year of worsening disease, repeated testing confirmed the presence of antibodies directed against all 6 of the implicated antigens, supportive of our hypothesis that epitope spreading may occur in paraneoplastic pemphigus. Conclusions: Lichenoid eruptions may predispose to an early evolutionary stage of paraneoplastic pemphigus. Cell-mediated autoimmunity at the dermoepidermal junction may promote the exposure of self- antigens and the development of subsequent and progressive humoral autoimmunity. As such, paraneoplastic pemphigus may demonstrate epitope spreading in a human, humoral-mediated autoimmune disease.

Original languageEnglish (US)
Pages (from-to)652-656
Number of pages5
JournalArchives of Dermatology
Volume136
Issue number5
StatePublished - May 2000

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Pemphigus
Dermatitis
Epitopes
Lichen Planus
Autoimmunity
Antigens
Lichenoid Eruptions
Desmoglein 3
Desmoglein 1
Autoantigens
Indirect Fluorescent Antibody Technique
Immunoprecipitation
Autoantibodies
Autoimmune Diseases
Urinary Bladder
Proteins
Inflammation
Antibodies

ASJC Scopus subject areas

  • Dermatology

Cite this

Bowen, G. M., Peters, N. T., Fivenson, D. P., Su, L. D., Nousari, H. C., Anhalt, G. J., ... Stevens, S. R. (2000). Lichenoid dermatitis in paraneoplastic pemphigus: A pathogenic trigger of epitope spreading? Archives of Dermatology, 136(5), 652-656.

Lichenoid dermatitis in paraneoplastic pemphigus : A pathogenic trigger of epitope spreading? / Bowen, Glen M.; Peters, Neill T.; Fivenson, David P.; Su, Lyndon D.; Nousari, Hossein C.; Anhalt, Grant James; Cooper, Kevin D.; Stevens, Seth R.

In: Archives of Dermatology, Vol. 136, No. 5, 05.2000, p. 652-656.

Research output: Contribution to journalArticle

Bowen, GM, Peters, NT, Fivenson, DP, Su, LD, Nousari, HC, Anhalt, GJ, Cooper, KD & Stevens, SR 2000, 'Lichenoid dermatitis in paraneoplastic pemphigus: A pathogenic trigger of epitope spreading?', Archives of Dermatology, vol. 136, no. 5, pp. 652-656.
Bowen GM, Peters NT, Fivenson DP, Su LD, Nousari HC, Anhalt GJ et al. Lichenoid dermatitis in paraneoplastic pemphigus: A pathogenic trigger of epitope spreading? Archives of Dermatology. 2000 May;136(5):652-656.
Bowen, Glen M. ; Peters, Neill T. ; Fivenson, David P. ; Su, Lyndon D. ; Nousari, Hossein C. ; Anhalt, Grant James ; Cooper, Kevin D. ; Stevens, Seth R. / Lichenoid dermatitis in paraneoplastic pemphigus : A pathogenic trigger of epitope spreading?. In: Archives of Dermatology. 2000 ; Vol. 136, No. 5. pp. 652-656.
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