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Vancomycin-Induced Linear IgA Bullous Dermatosis

Vancomycin-Induced Linear IgA Bullous Dermatosis Abstract To the Editor.— Linear IgA bullous dermatosis (LABD) is an idiopathic vesiculobullous disease with a nondiagnostic clinical appearance. It is best characterized pathologically by subepidermal bullous formation with homogeneous linear IgA deposition at the blister base.1-4 Although LABD is most often idiopathic, drug-induced disease may occur rarely.5,6 We describe a patient with vancomycin-induced LABD in whom the eruption was documented clinically, histopathologically, and immunologically on rechallenge. Report of a Case.— A 68-year-old man with coronary artery disease was admitted to the New England Deaconess Hospital (Boston) for a coronary artery bypass graft. On admission, his medications included atenolol, diltiazem hydrochloride, tolazamide (Tolinase) nitropaste, intravenous heparin, digoxin, and prazosin hydrochloride. There was no history of drug allergy. On hospital day 2, the patient underwent coronary artery bypass grafting, which was complicated by cardiogenic shock and acute tubular necrosis. An intra-aortic balloon pump and atrioventricular pacing was needed. Intravenously administered References 1. Wilson BD, Beutner EH, Kumar V, et al: Linear IgA bullous dermatosis, an immunologically defined disease . Int J Dermatol 1985;24:569-574.Crossref 2. Jones RR, Goolamali SK: IgA bullous pemphigoid: A distinct blistering disorder . Br J Dermatol 1980;102:719-725.Crossref 3. Chorzelski TP, Jablonska S, Beutner EH: Linear IgA bullous dermatosis , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 3. New York, John Wiley & Sons Inc, 1979, pp 407-420. 4. Lever W, Schaumburg-Lever G: Histopathology of the Skin , ed 6. Philadelphia, JB Lippincott, 1983, pp 113-122. 5. Gabrielsen TO, Staerfelt F: Drug-induced bullous dermatosis with linear IgA deposits along the basement membrane . Acta Derm Venereol 1981;61:439-441. 6. McWhirter JD, Hashimoto K, Fayne S, et al: Linear IgA bullous dermatosis related to lithium carbonate . Arch Dermatol 1987;123:1120-1122.Crossref 7. Marsden RA, McKee PH, Bhogal B, et al: A study of benign chronic bullous dermatosis of childhood and comparison with dermatitis herpetiformis and bullous pemphigoid occurring in childhood . Clin Exp Dermatol 1980;5:159-172.Crossref 8. Hwang R, Rodman OG: Chronic bullous dermatosis of childhood: A vesicular variant (linear IgA dermatosis) . J Invest Dermatol 1985;24:241-242.Crossref 9. Leonard JN, Haffenden GP, Ring NP, et al: Linear IgA disease in adults . Br J Dermatol 1982;107:301-316.Crossref 10. Aboobaker J, Bhogal B, Wojnarowska F, et al: The localization of the binding site of circulation IgA antibodies in linear IgA disease of adults, chronic bullous disease of childhood, and childhood cicatricial pemphigoid . Br J Dermatol 1987;116:293-302.Crossref 11. Fellner MI, Katz JM: Occurrence of bullous pemphigoid after furosemide therapy . Arch Dermatol 1976;112:75-77.Crossref 12. Brown MD, Dubin HV: Penicillamine-induced bullous pemphigoid— like eruption . Arch Dermatol 1987;123:1119-1120.Crossref 13. Bart BJ, Bean SF: Bullous pemphigoid following the topical use of fluorouracil . Arch Dermatol 1970;102:457-460.Crossref 14. Kashihara M, Danno K, Miyachi Y, et al: Bullous pemphigoid—like lesions induced by phenacetin . Arch Dermatol 1984;120:1196-1199.Crossref 15. Amer MH, Akhtar M, Mackey DM, et al: Bullous pemphigoid after chemotherapy for choriocarcinoma . Int J Dermatol 1982;21:32-35.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Vancomycin-Induced Linear IgA Bullous Dermatosis

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References (18)

Publisher
American Medical Association
Copyright
Copyright © 1988 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1988.01670080012007
Publisher site
See Article on Publisher Site

Abstract

Abstract To the Editor.— Linear IgA bullous dermatosis (LABD) is an idiopathic vesiculobullous disease with a nondiagnostic clinical appearance. It is best characterized pathologically by subepidermal bullous formation with homogeneous linear IgA deposition at the blister base.1-4 Although LABD is most often idiopathic, drug-induced disease may occur rarely.5,6 We describe a patient with vancomycin-induced LABD in whom the eruption was documented clinically, histopathologically, and immunologically on rechallenge. Report of a Case.— A 68-year-old man with coronary artery disease was admitted to the New England Deaconess Hospital (Boston) for a coronary artery bypass graft. On admission, his medications included atenolol, diltiazem hydrochloride, tolazamide (Tolinase) nitropaste, intravenous heparin, digoxin, and prazosin hydrochloride. There was no history of drug allergy. On hospital day 2, the patient underwent coronary artery bypass grafting, which was complicated by cardiogenic shock and acute tubular necrosis. An intra-aortic balloon pump and atrioventricular pacing was needed. Intravenously administered References 1. Wilson BD, Beutner EH, Kumar V, et al: Linear IgA bullous dermatosis, an immunologically defined disease . Int J Dermatol 1985;24:569-574.Crossref 2. Jones RR, Goolamali SK: IgA bullous pemphigoid: A distinct blistering disorder . Br J Dermatol 1980;102:719-725.Crossref 3. Chorzelski TP, Jablonska S, Beutner EH: Linear IgA bullous dermatosis , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 3. New York, John Wiley & Sons Inc, 1979, pp 407-420. 4. Lever W, Schaumburg-Lever G: Histopathology of the Skin , ed 6. Philadelphia, JB Lippincott, 1983, pp 113-122. 5. Gabrielsen TO, Staerfelt F: Drug-induced bullous dermatosis with linear IgA deposits along the basement membrane . Acta Derm Venereol 1981;61:439-441. 6. McWhirter JD, Hashimoto K, Fayne S, et al: Linear IgA bullous dermatosis related to lithium carbonate . Arch Dermatol 1987;123:1120-1122.Crossref 7. Marsden RA, McKee PH, Bhogal B, et al: A study of benign chronic bullous dermatosis of childhood and comparison with dermatitis herpetiformis and bullous pemphigoid occurring in childhood . Clin Exp Dermatol 1980;5:159-172.Crossref 8. Hwang R, Rodman OG: Chronic bullous dermatosis of childhood: A vesicular variant (linear IgA dermatosis) . J Invest Dermatol 1985;24:241-242.Crossref 9. Leonard JN, Haffenden GP, Ring NP, et al: Linear IgA disease in adults . Br J Dermatol 1982;107:301-316.Crossref 10. Aboobaker J, Bhogal B, Wojnarowska F, et al: The localization of the binding site of circulation IgA antibodies in linear IgA disease of adults, chronic bullous disease of childhood, and childhood cicatricial pemphigoid . Br J Dermatol 1987;116:293-302.Crossref 11. Fellner MI, Katz JM: Occurrence of bullous pemphigoid after furosemide therapy . Arch Dermatol 1976;112:75-77.Crossref 12. Brown MD, Dubin HV: Penicillamine-induced bullous pemphigoid— like eruption . Arch Dermatol 1987;123:1119-1120.Crossref 13. Bart BJ, Bean SF: Bullous pemphigoid following the topical use of fluorouracil . Arch Dermatol 1970;102:457-460.Crossref 14. Kashihara M, Danno K, Miyachi Y, et al: Bullous pemphigoid—like lesions induced by phenacetin . Arch Dermatol 1984;120:1196-1199.Crossref 15. Amer MH, Akhtar M, Mackey DM, et al: Bullous pemphigoid after chemotherapy for choriocarcinoma . Int J Dermatol 1982;21:32-35.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Aug 1, 1988

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