title: Penicillin-induced anti-p200 pemphigoid: an unusual morphology.
abstract: We report here a case of a 52-year-old woman with erythema gyratum repens-like lesions appearing during anti-p200 pemphigoid, probably induced by oral penicillin. The diagnosis of anti-p200 pemphigoid was made by the presence of in vivo bound and circulating IgG anti-basement membrane zone auto-antibody reactive with the dermal side of salt-split skin and with 200 kDa protein in dermal extract on Western immunoblot. Laser scanning confocal microscopic study disclosed the localization of IgG at the lamina lucida-lamina densa border. Skin lesions responded poorly to high dose of prednisone and the combination of prednisone and dapsone. When methotrexate was added, skin lesions healed within 3 weeks. To our knowledge, erythema gyratum repens-like lesions have not been described previously in this disorder. Thus, we have expanded the clinical morphological spectrum of patients with anti-p200 pemphigoid and first described a patient whose disorder was probably drug-induced.
authors.affiliation: Department of Dermatology, Medical University of Warsaw, PL-02008 Warsaw, Poland. kwoznia@amwaw.edu.pl
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Wozniak
authors.forename: Cezary
authors.initials: C
authors.lastname: Kowalewski
authors.forename: Takashi
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Norito
authors.initials: N
authors.lastname: Ishii
authors.forename: Maria
authors.initials: M
authors.lastname: Glinska-Wielochowska
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schwartz
mesh_terms: D001323:Autoantibodies / Q000032:analysis; D001327:Autoimmune Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000276:immunology; D004890:Erythema / Q000139:chemically induced / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000139:chemically induced* / Q000188:drug therapy / Q000276:immunology; D010406:Penicillins / Q000009:adverse effects*; D011241:Prednisone / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D001323:Autoantibodies; D007074:Immunoglobulin G; D010406:Penicillins; D011241:Prednisone; D008727:Methotrexate