Ramipril-associated lichen planus pemphigoides.
We report the first case of lichen planus pemphigoides (LPP) secondary to ingestion of ramipril, an angiotensin-converting enzyme inhibitor. Clinical, histological and immunofluorescent findings were all consistent with a diagnosis of LPP. Linear basement membrane zone (BMZ) staining with IgG and C3 was only seen at the roof of split-skin preparations and circulating autoantibody to the BMZ was present at a titre of 1/100. Controlled immunoblotting of epidermal extracts detected the bullous pemphigoid antigens of 230 and 180 kDa.
Ogg
G S
GS
St John's Institute of Dermatology, St Thomas' Hospital, London, U.K.
Bhogal
B S
BS
Hashimoto
T
T
Coleman
R
R
Barker
J N
JN
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D001323:Autoantibodies / Q000032:analysis; D001324:Autoantigens / Q000276:immunology; D002352:Carrier Proteins; D003094:Collagen; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D006801:Humans; D015151:Immunoblotting; D008010:Lichen Planus / Q000139:chemically induced* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D017257:Ramipril / Q000009:adverse effects*; D012867:Skin / Q000276:immunology / Q000473:pathology; D012872:Skin Diseases, Vesiculobullous / Q000139:chemically induced* / Q000276:immunology; D000097805:Collagen Type XVII
D000806:Angiotensin-Converting Enzyme Inhibitors; D001323:Autoantibodies; D001324:Autoantigens; D002352:Carrier Proteins; D003094:Collagen; D003598:Cytoskeletal Proteins; D000071821:Dystonin; D009419:Nerve Tissue Proteins; D024041:Non-Fibrillar Collagens; D017257:Ramipril; D000097805:Collagen Type XVII; C486268:DST protein, human