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Paraneoplastic pemphigus presenting as a prodrome to aggressive T cell lymphoma
  1. Asha Bansari1,
  2. Jodi Anne Wallace2,
  3. Lijun Yang2 and
  4. Atul Kapoor2
  1. 1 Medicine, University of Florida, Gainesville, Florida, USA
  2. 2 University of Florida, Gainesville, Florida, USA
  1. Correspondence to Dr Asha Bansari; asha.bansari{at}


Paraneoplastic pemphigus (PNP) is a rare disease with an unclear mechanism of pathogenesis. We present a case of a male patient who presented with wound management after being diagnosed with Castleman disease-associated paraneoplastic pemphigus (PNP). The patient’s condition was not improving; as a result, extensive workup was repeated, which confirmed the diagnosis of aggressive T cell lymphoblastic lymphoma. Our case signifies the importance of keeping a high index of suspicion for PNP-associated malignancies. This case report also adds emphasis to the diagnostic challenges faced by clinicians, making clinical correlation with multidisciplinary approach essential. Therefore, if clinically indicated, we need to revisit the diagnosis and seek alternative explanations to prevent delays in management.

  • Malignant disease and immunosuppression
  • Pathology

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  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagram and algorithms, and critical revision for important intellectual content: AB, JAW, LY, and AK; AB started working on the initial draft text, sourcing and editing clinical images, investigation results and critical revision of the content and also completed patient consent form after discussion with AK. JAW edited the draft text, reviewed with critical revision for important intellectual content and updated formatting references with formatting as recommended by the BMJ author guidelines. LJ completed the pathology slide and legends for pathology slides with explanation. AK reviewed and edited the case after the final draft was completed with critical revision. The following authors gave final approval of the manuscript: AB, JAW, LY and AK.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.