A biological approach in a patient with psoriasis and bullous pemphigoid associated with losartan therapy.
Several cases of psoriasis associated with bullous disorders have been reported, and it is clearly recognized that bullous pemphigoid (BP) is the most common bullous disorder observed in association with psoriasis, especially after ultraviolet (UV)B and psoralen UVA therapy. Moreover, other medications have been repeatedly reported to induce bullous diseases, especially pemphigus vulgaris. We report for the first time a case of BP possibly induced by losartan, an angiotensin II antagonist, in a patient with a severe psoriatic background. Angiotensin II type 1 receptor antagonists belong to a new class of drug for hypertension or congestive heart failure with established efficacy and few side-effects. Coexistence of psoriasis vulgaris with bullous diseases represents also a difficult therapeutic challenge. This rare case of psoriasis and generalized BP triggered by a sartan drug was treated with rituximab and etanercept.
Saraceno
R
R
Department of Dermatology, University of Rome Tor Vergata, Rome, Italy. rositasaraceno@yahoo.it
Citarella
L
L
Spallone
G
G
Chimenti
S
S
D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived; D003875:Drug Eruptions / Q000209:etiology / Q000473:pathology; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D019808:Losartan / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D010391:Pemphigoid, Bullous / Q000139:chemically induced* / Q000473:pathology; D011565:Psoriasis / Q000188:drug therapy* / Q000473:pathology; D000069283:Rituximab; D016896:Treatment Outcome
D047228:Angiotensin II Type 1 Receptor Blockers; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab; D019808:Losartan