Histopathologic findings in drug-induced pemphigus.
Drug-induced pemphigus represents a diagnostic challenge, as usually no clinical feature differentiates it from its idiopathic counterpart. It was suggested recently that some histologic features may assist in diagnosing drug-associated diseases. The purpose of the study was to determine whether the histologic criteria suggested in the literature are specific enough to arouse suspicion of drug-induced pemphigus. Biopsy specimens of drug-induced and idiopathic pemphigus were reviewed by five dermatologists with no clinical data available about the patients. The sections were assessed to the presence of spongiosis with eosinophils, vacuolar degeneration, and the degree of acantholysis and cleavage level. Using the suggested criteria, the reviewers were unable to confirm a diagnosis of drug-induced pemphigus. It is advisable to consider drug etiology in every case of newly diagnosed pemphigus based on clinical criteria an detailed drug consumption history, as histologic features do not differentiate between drug-associated and idiopathic disease.
Landau
M
M
Department of Dermatology, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Brenner
S
S
D000051:Acantholysis / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001706:Biopsy; D003023:Cloxacillin / Q000009:adverse effects; D003937:Diagnosis, Differential; D004177:Dipyrone / Q000009:adverse effects; D003875:Drug Eruptions / Q000473:pathology*; D004358:Drug Therapy; D004804:Eosinophils / Q000473:pathology; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000473:pathology; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009336:Necrosis; D010392:Pemphigus / Q000139:chemically induced* / Q000473:pathology; D010406:Penicillins / Q000009:adverse effects; D013752:Tetracycline / Q000009:adverse effects; D014617:Vacuoles / Q000648:ultrastructure
D000900:Anti-Bacterial Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D010406:Penicillins; D004177:Dipyrone; D000658:Amoxicillin; D013752:Tetracycline; D003023:Cloxacillin