PEMFIGOIDE BOLLOSO DOPO RADIOTERAPIA

Bullous pemphigoid is a chronic autoimmune disease which can be induced by several causes; physical factors such as ultraviolet rays, traumas and ionizing radiation, seem to be possible etiological agents. Ionizing radiation can induce a rare form of bullous pemphigoid in a patient who had received a course of radiotherapy after partial right mastectomy for ductal carcinoma. Bullous manifestations developed in the irradiated areas only twenty days after suspension of radiotherapy. The followiug skin lesions were localized in the trunk and in the arms. In the documented case the relation between skin bullous lesions and ionizing radiation is underlined by the short time gone by between the occurrence of the skin lesions and the irradiation, and by the localization in the irradiated areas. Very few cases have been reported in literature, especially considering the frequent use of ionizing radiations in the treatment of malignant neoplasm. This suggests either the possibility of a genetic predisposition in these patients or, alternatively, the presence of a subclinical form of a bullous disease. The authors consider the various pathogenetical possibilities, and suggest that ionizing radiation is responsible for the exposure of bullous pemphigoid antigen with consequent autoimmunization and production of auto-antibodies against such antigen. The authors also point out the prompt response to therapy with 6-methylprednisolone.