Drug-induced epidermolysis bullosa acquisita with antibodies to type VII collagen.
We describe a 73-year-old patient who had a subepidermal bullous eruption develop after a course of antibiotics, including vancomycin. The patient had deposits of IgA and IgG in the cutaneous basement membrane zone that were located on the dermal side of 1 M NaCl-treated autologous skin. By an enzyme-linked immunosorbent assay, the patient was found to have circulating IgG antibodies directed against type VII collagen, the target antigen of epidermolysis bullosa acquisita. Our observation expands the spectrum of immune-mediated subepidermal bullous skin eruptions precipitated by drugs and lends support to the idea that a subset of these cases represents an unusual variant of drug-triggered epidermolysis bullosa acquisita.
Delbaldo
Catherine
C
Department of Internal Medicine, University Hospital, Geneva, Switzerland.
Chen
Mei
M
Friedli
André
A
Prins
Christa
C
Desmeules
Jules
J
Saurat
Jean-Hilaire
JH
Woodley
David T
DT
Borradori
Luca
L
D000230:Adenocarcinoma / Q000188:drug therapy / Q000601:surgery; D000368:Aged; D001323:Autoantibodies / Q000276:immunology*; D001707:Biopsy, Needle; D003094:Collagen / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D016107:Epidermolysis Bullosa Acquisita / Q000139:chemically induced* / Q000276:immunology* / Q000473:pathology; D019085:Fluorescent Antibody Technique, Direct; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D010190:Pancreatic Neoplasms / Q000188:drug therapy / Q000601:surgery; D013530:Surgical Wound Infection / Q000517:prevention & control; D014640:Vancomycin / Q000008:administration & dosage / Q000009:adverse effects*
D001323:Autoantibodies; D005839:Gentamicins; D014640:Vancomycin; D003094:Collagen