Pemphigus vulgaris has never before been associated with silicosis, although there are many reports of silicosis accompanied by several autoimmune diseases such as progressive systemic sclerosis, systemic lupus erythematosus, dermatomyositis or rheumatoid arthritis. We observed a patient with pemphigus vulgaris accompanied with silicosis. The patient was a 75-year-old man with a 2-month history of repeated oral erosions and blisters on the back, thighs and axillas. Histological examination showed suprabasal cleavage with acantholysis. Immunoblotting analysis demonstrated binding of the patient’s serum to the 130-kD pemphigus vulgaris antigen (desmoglein 3) and the 160-kD pemphigus foliaceus antigen (desmoglein 1). The patient has radiographically been diagnosed as having silicosis. An elevated serum IgG, antinuclear antibody, anti-ssDNA, antimicrosomal antibodies and a biologically false-positive reaction to the Wassermann test were also detected. Although the clinical symptoms improved after treatment with systemic steroids, the patient died due to pneumonia. This is the first reported case in which the characteristics of both pemphigus vulgaris and silicosis could be detected.

1.
Moll R, Bahn H, Bayerl C, Moll I: Cell adhesion molecules and extracellular matrix components as target structures of autoimmunity. Verh Dtsch Ges Pathol 1996;80:67–79.
2.
Joly P, Gilbert D, Thomine E, Zitouni M, Ghohestani R, Delpech A, Lauret P, Tron F: Identification of a new antibody population directed against a desmosomal plaque antigen in pemphigus vulgaris and pemphigus foliaceus. J Invest Dermatol 1997;108:469–475.
3.
Hashimoto T, Amagai M, Garrod DR, Nishikawa T: Immunofluorescence and immunoblot studies on the reactivity of pemphigus vulgaris and pemphigus foliaceus sera with desmoglein 3 and desmoglein 1. Epithelial Cell Biol 1995; 4:63-69.
4.
Rodnan GP, Benedek TG, Medsger TA Jr, Cammarata RJ: The association of progressive systemic sclerosis (scleroderma) with coal miners’ pneumoconiosis and other forms of silicosis. Ann Intern Med 1967;66:323–334.
5.
Haustein UF, Ziegler V, Herrmann K: Silica-induced scleroderma. J Am Acad Dermatol 1990;22:444–448.
6.
Hatron PY, Plouvier B, François M: Association de lupus érythémateux et silicose. Rev Méd Interne 1982;30:8–15.
7.
Cledes J, Hervé JP, Clavier J: Silicose pulmonaire et lupus érythémateux disséminé. Poumon Cœur 1983;39:205–207.
8.
Sanches RJ, Wichmann I, Salaberri J: Multiple clinical and biological autoimmune manifestations in 50 workers after occupational exposure to silica. Ann Rheum Dis 1993;52:534–538.
9.
Caplan A: Certain unusual radiological appearance in the chest of coalminers suffering from rheumatoid arthritis. Thorax 1953;8:29–37.
10.
Breathnach SM: Mechanisms of drug eruptions. Part 1. Australas J Dermatol 1995;36: 121–127.
11.
Pisani M, Ruocco V: Drug induced pemphigus. Clin Dermatol 1986;4:118–132.
12.
Civatte J: Drug-induced pemphigus: Clinical review and pathogenic mechanism. Bull Acad Natl Med 1986;170:1057–1063.
13.
Krain LS: Pemphigus: Epidemiologic and survival characteristics of 59 patients, 1955–1973. Arch Dermatol 1974;110:862–865.
14.
Brandsen R, Frusic Zlotkin M, Lyubimov H, Yunes F, Michel B, Tamir A, Milner Y, Brenner S: Circulating pemphigus IgG in families of patients with pemphigus: Comparison of indirect immunofluorescence and direct immunofluorescence, and immunoblotting. J Am Acad Dermatol 1997;36:44–52.
15.
Ueki A, Yamaguchi M, Ueki H: Polyclonal human T-cell activation by silicate in vitro. Immunology 1994;82:332–335.
16.
Tomokuni A, Aikoh T, Ueki H, Ueki A: Elevated soluble Fas/APO-1 (CD95) levels in silicosis patients without clinical symptoms of autoimmune diseases or malignant tumours. Clin Exp Immunol 1997;110:303–309.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.