A-75-year-old Japanese man who was diagnosed with bullous pemphigoid (BP) did not respond to systemic steroid therapy, but he achieved remission by a combination of repetitive treatment with intravenous immunogloblin (IVIG) infusions as an adjuvant therapy. He exhibited marked thrombocytopenia after every IVIG therapy, but recoverd naturally within a few weeks. IVIG therapy provides a beneficial therapeutic outcome for patients with BP who are resistant to steroid therapy; however, we must be alert to the possibility of thrombocytopenia.
Paronychia associated with epidermal growth factor receptor inhibitors (EGFRIs) can impair the QOL of patients treated with EGFRIs due to regular treatment and pain. Therefore, it may cause reduction or withdrawal of EGFRIs. We carried out partial nail avulsion for paronychia associated with EGFRIs, and then compared patients' DLQI and VAS before and after the avulsion. The results showed that both DLQI total score and VAS score were significantly improved by nail avulsion (p<0.0001). After nail avulsion, no paronychia recurred within approximately 6 months, and none of patients needed reduction or withdrawal of EGFRIs during follow-up period. In conclusion, partial nail avulsion for paronychia can improve patients' pain and QOL, thus increasing the tolerability of EGFRIs.