Coexistence of Bullous Pemphigoid, Intrahepatic Cholangiocarcinoma, and Alopecia Areata: A Case Report of Multifactorial Autoimmunity in a Surgical Context

This case report describes the first known coexistence of bullous pemphigoid, intrahepatic cholangiocarcinoma, and alopecia areata in a 67-year-old male. The patient developed bullous pemphigoid shortly after surgery for intrahepatic cholangiocarcinoma, without prior exposure to immunologic agents. Alopecia areata was diagnosed six months earlier, with spontaneous hair regrowth. Post-surgery, tumor markers normalized, and bullous pemphigoid lesions resolved with dupilumab therapy. The report suggests shared immunopathogenic mechanisms among these conditions and highlights the importance of monitoring autoimmune dermatoses in cancer patients with immune disorders. Further research is needed to understand the immune links between these diseases.