title: A critical reappraisal of the current data on drug-induced linear immunoglobulin A bullous dermatosis: a real and separate nosological entity?
abstract: BACKGROUND
  Linear IgA disease (LAD) has been associated with a variety of drugs over the past 30 years.
  
  
  OBJECTIVE
  To review current literature on all available cases of drug-induced LAD, in order to ascertain whether a close relationship is justified, so that it constitutes a real and separate nosological entity.
  
  
  METHODS
  The PubMed database was searched for all articles written in English related to drug-induced LAD published between January 1980 and December 2010.
  
  
  RESULTS
  The literature review shows that at least 84 articles were published, describing a total of 103 patients. Of these articles, only 46, from 13 countries, were included in this analysis, with a total of 52 patients: 24 (46.2%) were believed to be induced by vancomycin and 28 (53.8%) by drugs other than vancomycin. Challenge-dechallenge-rechallenge testing protocol was performed on only 6 (11.5%) of 52 patients, of which only 5 showed a positive result, while the Naranjo algorithm was performed on only 2 of them (0.3%).
  
  
  CONCLUSIONS
  The evidence of this review analysis is based only on case reports. No study on large samples of drug-induced LAD is currently available.
  
  
  CONCLUSIONS
  The literature analysis reveals no strong scientific evidence to support the notion that some drugs have induced LAD; therefore in many reviewed cases, we must question whether drug-induced LAD is really the underlying entity. Further and thorough investigations using one of the available algorithms for adverse drug reaction are warranted.
authors.affiliation: Department of Dermatology, Stanford University School of Medicine, Center for Clinical Sciences Research, Stanford, California 94305, USA. gfortuna@stanford.edu
authors.forename: Giulio
authors.initials: G
authors.lastname: Fortuna
authors.forename: Julio Cesar
authors.initials: JC
authors.lastname: Salas-Alanis
authors.forename: Eugenio
authors.initials: E
authors.lastname: Guidetti
authors.forename: M Peter
authors.initials: MP
authors.lastname: Marinkovich
mesh_terms: D000368:Aged; D000465:Algorithms; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001327:Autoimmune Diseases / Q000139:chemically induced*; D015551:Autoimmunity / Q000187:drug effects; D005260:Female; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012872:Skin Diseases, Vesiculobullous / Q000139:chemically induced* / Q000276:immunology; D014640:Vancomycin / Q000009:adverse effects*
chemical_list: D000900:Anti-Bacterial Agents; D007070:Immunoglobulin A; D014640:Vancomycin