Vancomycin-induced linear IgA bullous dermatosis with isomorphic response

Tatsuhiko Mori,Toshiyuki Yamamoto

doi:10.7241/ourd.20134.154

Abstract

Linear IgA bullous dermatosis (LABD) is occasionally induced by certain drugs, of which vancomycin is the most common. We herein describe a case of vancomycin-induced LABD on the trunk and extremities. Our case was unique in which tense bulla was induced on the old operation scars. A 92-year-old man developed diffuse erythema and bullas on his trunk and extremities. Also, blister formation was observed on the operation scar on the abdomen. A biopsy specimen showed subepidermal split with neutrophilic and lymphocytic infiltration in the upper dermis. Direct immunofluorescence showed a linear IgA deposition at the basement membrane zone. His skin conditions were improved by stoppage of vancomycin and topical corticosteroids. We should know about the occurrence of LABD in patients under vancomycin treatment.

Highlights

Linear IgA bullous dermatosis (LABD) is a rare autoimmune subepidermal bullous disease, characterized by linear IgA deposition at the basement membrane zone
LABD can be induced by various kinds of drugs such as vancomycin, rifampicin, penicillin, cephalosporin, amoxicillin, cefuroxime, captopril, lithium, metronidazole, trimetropin sulfametoxazol, furosemide, atorvastatin, amiodarone, diclofenac, and amlodipine
Certain drugs may elicit autoimmune responses, which lead to the break of self-tolerance to native antigens [3]

Summary

Introduction

Cite this article: Tatsuhiko Mori, Toshiyuki Yamamoto: Vancomycin-induced linear IgA bullous dermatosis with isomorphic response. Introduction Linear IgA bullous dermatosis (LABD) is a rare autoimmune subepidermal bullous disease, characterized by linear IgA deposition at the basement membrane zone. LABD is occasionally induced by certain drugs, of which vancomycin is the most common. Vancomycin-induced LABD shows various clinical features, such as dermatitis herpetiformis, erythema multiforme, toxic epidermal necrolysis, and erythroderma [1].

Results

Conclusion