PEMPHIGUS-VULGARIS ASSOCIATED WITH SILICOSIS

Pemphigus vulgaris has never before been associated with silicosis, al though there are many reports of silicosis accompanied by several auto immune diseases such as progressive systemic sclerosis, systemic lupus erythematosus, dermatomyositis or rheumatoid arthritis. We observed a patient with pemphigus vulgaris accompanied with silicosis. The patie nt was a 75-year-old man with a 2-month history of repeated oral erosi ons and blisters on the back, thighs and axillas. Histological examina tion showed suprabasal cleavage with acantholysis. Immunoblotting anal ysis demonstrated binding of the patient's serum to the 130-kD pemphig us vulgaris antigen (desmoglein 3) and the 160-kD pemphigus foliaceus antigen (desmoglein 1). The patient has radiographically been diagnose d as having silicosis. An elevated serum IgG, antinuclear antibody, an ti-ssDNA, antimicrosomal antibodies and a biologically false-positive reaction to the Wassermann test were also detected. Although the clini cal symptoms improved after treatment with systemic steroids, the pati ent died due to pneumonia. This is the first reported case in which th e characteristics of both pemphigus vulgaris and silicosis could be de tected.