Drug-induced linear immunoglobulin A bullous dermatosis mimicking Stevens-Johnson syndrome: a case report

• Published in: Cutis (New York, N.Y.) Vol. 79; no. 3; p. 203
• Main Authors: Cummings, Julie E, Snyder, Renee R, Kelly, Erica B, Raimer, Sharon S
• Format: Journal Article
• Language: English
• Published: United States 01.03.2007
• Subjects: Anti-Infective Agents - adverse effects; Autoimmune Diseases - chemically induced; Autoimmune Diseases - pathology; Azithromycin - adverse effects; Diagnosis, Differential; Drug Eruptions - drug therapy; Drug Eruptions - pathology; Fluorescent Antibody Technique, Direct; Humans; Immunoglobulin A - immunology; Male; Middle Aged; Rimantadine - adverse effects; Skin - pathology; Skin Diseases, Vesiculobullous - chemically induced; Skin Diseases, Vesiculobullous - drug therapy; Skin Diseases, Vesiculobullous - pathology; Stevens-Johnson Syndrome - diagnosis; Zanamivir - adverse effects
• ISSN: 0011-4162

Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is a rare autoimmune disorder characterized by vesiculobullous mucocutaneous eruptions. LABD also has been reported as a drug-induced reaction. Idiopathic LABD and drug-induced LABD are clinically indistinguishable and can resemble bullous pemphigoid, dermatitis herpetiformis, or bullous erythema multiforme. LABD is diagnosed with direct immunofluorescence (DIF), and idiopathic LABD can be distinguished from drug-induced LABD with a careful medication history. We present the case of a 54-year-old man with drug-induced LABD after ingestion of rimantadine, zanamivir, and azithromycin for presumed influenza. The patient's bullous eruption resolved with discontinuation of the offending medications and treatment with prednisone and pentoxifylline.