Abstract
Pemphigoid diseases are a group of blistering autoimmune pathologies including pemphigus vulgaris (PV) and pemphigus foliaceous, which affect mucocutaneous tissues. Non-steroidal anti-inflammatory drugs, penicillamine, and angiotensin-converting enzyme inhibitors such as captopril and enalapril are associated with drug-induced pemphigoid. We present a case of lisinopril-associated PV which has not been previously reported.
Highlights
Pemphigus diseases (PD) are a group of blistering pathologies caused by an autoimmune response to structural proteins called desmogleins (DG) that allow for cell-cell adhesion within the skin and mucous membranes
Histological, and immunological presentations, PD are subdivided into four subtypes, including pemphigus vulgaris (PV), pemphigus foliaceous (PF), paraneoplastic pemphigus, and immunoglobulin (Ig) A pemphigus [1]
Drug-induced PD (DIP) is a well-known entity that is attributed to multiple agents such as non-steroidal anti-inflammatory drugs (NSAIDs), penicillamine, and angiotensinconverting enzyme inhibitors (ACEI) [5]
Summary
Pemphigus diseases (PD) are a group of blistering pathologies caused by an autoimmune response to structural proteins called desmogleins (DG) that allow for cell-cell adhesion within the skin and mucous membranes. The patient denied a concomitant history of fatigue, low-grade fevers, photosensitivity, nasal/nasopharyngeal ulcerations, malar/discoid rash, arthiritis, artharalgias, mylagias, pleuritic/inspiratory chest pain, easy bruising, recurrent infections, anemia, seizures, or psychosis His past medical history was negative for PD, allergies, and autoimmune disease(s). The patient’s lisinopril was discontinued and he was started on a prednisone taper, starting at 50 mg OD for two weeks with recommendations to decrease by 10 mg every two weeks Following this regimen, the patient noted mild improvement in his dysphagia and odynophagia; his oral lesions continued to persist. The patient noted mild improvement in his dysphagia and odynophagia; his oral lesions continued to persist He was recommended to undergo a repeat EGD for subsequent follow-up of his esophageal lesions but denied this intervention. He is currently being followed up as an outpatient with monthly CBC and CMP with plans to repeat DG antibodies every six months till a complete resolution of his symptoms
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