Paraneoplastischer Pemphigus bei hochmalignem Non-Hodgkin-Lymphom bei einem Patienten mit Psoriasis pustulosa unter Therapie mit Infliximab

Zusammenfassung

Wir berichten über einen 54-jährigen Patienten mit Psoriasis pustulosa Typ Zumbusch, der erstmalig unter interner Therapie mit Infliximab an einem paraneoplastischen Pemphigus vulgaris bei erstdiagnostiziertem Non-Hodgkin-Lymphom erkrankte, mit letztlich letalem Ausgang bei insgesamt progredientem Tumorleiden.

Abstract

We present a 54-year old man with generalized pustular psoriasis who developed a paraneoplastic pemphigus due to a non Hodgkin lymphoma for the first time while being treated with infliximab. The progress of the lymphoma was lethal.

Literatur

• 1 Zhu X, Zhang B. Paraneoplastic Pemphigus.  J Dermatol.. 2007;  34 503-511
• 2 Batista M D, Takano D, Lopes R D. et al . Paraneoplastic pemphigus associated with non-Hodgkin lymphoma.  Dermatol Online J. 2008;  14 11
• 3 Hoque S R, Black M M, Cliff S. Paraneoplastic pemphigus associated with CD20-positive follicular non-Hodgkin’s lymphoma treated with rituximab: a third case resistant to rituximab therapy.  Clin Exp Dermatol. 2007;  32 172-175
• 4 Duparc A, Boivin S, Gilbert D. et al . Paraneoplastic pemphigus with pemphigus vegetans-like lesions revealing non-hodgkin lymphoma.  Eur J Dermatol. 2006;  16 698-699
• 5 Chaudhari U, Romano P, Mulcahy L D. et al . Efficacy and safety of infliximab monotherapy for plaque-type psoriasis: a randomised trial.  Lancet. 2001;  357 1842-1847
• 6 Reich K, Nestle F O, Papp K. et al . Infliximab induction and maintenance therapy for moderate-to-severe psoriasis: a phase III, multicentre, double-blind trial.  Lancet. 2005;  366 1367-1374
• 7 Newland M R, Weinstein A, Kerdel F. Rapid response to infliximab in severe pustular psoriasis, von Zumbusch type.  Int J Dermatol. 2002;  41 449-452
• 8 Schmick K, Grabbe J. Recalcitrant, generalized pustular psoriasis: rapid and lasting therapeutic response to antitumour necrosis factor-alpha antibody (infliximab).  Br J Dermatol. 2004;  150 367
• 9 Routhouska S B, Sheth P B, Korman N J. Long-term management of generalized pustular psoriasis with infliximab: case series.  J Cutan Med Surg. 2008;  12 184-188
• 10 Wolfe F, Michaud K. The effect of methotrexate and anti-tumor necrosis factor therapy on the risk of lymphoma in rheumatoid arthritis in 19 562 patients during 89 710 person-years of observation.  Arthritis Rheum. 2007;  56 1433
• 11 Askling J, Fored C M, Baecklund E. et al . Haematopoietic malignancies in rheumatoid arthritis: lymphoma risk and characteristics after exposure to tumour necrosis factor antagonists.  Ann Rheum Dis. 2005;  64 1414-1420
• 12 Gelfand J M, Berlin J, Van Voorhees A. et al . The Risk of Lymphoma in Patients with Psoriasis.  Journal of Investigative Dermatology. 2006;  126 2194-2201
• 13 Brown E R, Charles K A, Hoare S A. et al . A clinical study assessing the tolerability and biological effects of infliximab, a TNF-alpha inhibitor, in patients with advanced cancer.  Ann Oncol. 2008;  19 1340-1346
• 14 Brown S L, Greene M H, Gershon S K. et al . Tumor necrosis factor antagonist therapy and lymphoma development: twenty-six cases reported to the Food and Drug Administration.  Arthritis Rheum. 2002;  Dec 46 3151-3158
• 15 Paul C F, Ho V C, McGeown C. et al . Risk of Malignancies in Psoriasis Patients Treated with Cyclsporine: a 5 y Cohort Study.  J Invest Dermatol. 2003;  120 211-216
• 16 Väkevä L, Reitamo S, Pukkala E. et al . Long-term follow-up of cancer risk in patients treated with short-term cyclosporine.  Acta Derm Venereol. 2008;  88 117-120

1 Wir danken herzlich für die unterstützende dermatohistologische Beurteilung des Labors Dr. Laaff, Freiburg.