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Cutaneous Manifestations of Thymoma-associated Multi-organ Autoimmunity: A Fatal Sign.

Association of thymoma and cutaneous autoimmune disorder has been reported previously. Paraneoplastic pemphigus (PNP) and lichen planus (LP) have been commonly reported as cutaneous complications of thymoma (1, 2). Thymoma-associated multi-organ autoimmunity (TAMA) is a rare paraneoplastic disease that presents manifestations resembling graft-versus-host disease (GVHD) in thymoma. TAMA tends to have an unfavourable prognosis, due to complications of infectious diseases (3, 4). Of the several case reports of TAMA, 4 in the English literature were without extracutaneous GVHD-like manifestations (3, 5–7). Of these, only one case with a fatal outcome has been described (7). We describe here the first case of TAMA developing GVHD-like manifestation solely in the skin, who died of progressive multifocal leukoencephalopathy (PML) one year after being diagnosed with TAMA.