Previously reported cases have shown a temporal association between cicatricial pemphigoid and systemic solid malignancies, including non‐small cell lung cancer (adenocarcinoma, squamous cell, large cell), gastric adenocarcinoma and endometrial adenocarcinoma.2,3,4,5,6,7,8
In some patients, the pemphigoid responded to chemotherapy or surgical resection of the tumour, suggesting a paraneoplastic process.2,6,8
Antibodies to laminin‐5, a basement membrane protein elaborated by lung and gastrointestinal epithelia, have been found in patients with cicatricial pemphigoid and lung and gastric cancers.2,3,4,6,8
Aberrant synthesis of laminin‐5 by tumour cells, or tumour‐related inflammation and invasion, may expose the antigen to the immune system.2,9
Pemphigus, an autoimmune disease characterised by intraepithelial blisters, can also present as a paraneoplastic process, although it is primarily associated with lymphoreticular malignancies.10
In a similar reported case of paraneoplastic pemphigoid, the diagnosis of squamous cell lung cancer was made 2 months after the patient developed cicatrising conjunctivitis.7
The differential diagnosis for cicatrising conjunctivitis is broad and includes OCP, Stevens Johnsons syndrome, chemical burns, radiation, toxic conjunctivitis, post‐infectious conjunctivitis, graft versus host disease, atopic keratoconjunctivitis and conjunctival squamous cell carcinoma.1
Paraneoplastic pemphigoid should also be considered in the differential diagnosis, and this case illustrates the importance of obtaining a pertinent history and review of systems.