Vancomycin-induced linear IgA bullous dermatosis: associations.
Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering disease. LABD is considered mostly idiopathic, butsome cases have been reported to be drug-induced, mainly associated with vancomycin (VCM).We present two cases of LABD possibly associated with VCM used for cardiac surgery prophylaxis; in the presented cases, the eruptions occurred only after VCM withdrawal, therefore leaving a question about the relationship between VCM and LABD in these cases.We reviewed previous reports of VCM-induced LABD and analyzed the following parameters: gender, age, recent medical history, concurrent medication, latency period, progression after withdrawal, time to resolution, treatment, and rechallenge.


RESULTS
The causal relationship between VCM and LABD was often unclear; patients frequently had concurrent medication and symptoms frequently began and/or progressed after VCM withdrawal. Among the 46 reviewed patients in addition to our two cases (n=48), 20 (42%) had recent history of cardiac procedure, cardiac infection, congestive heart failure, or aortic aneurism.


CONCLUSIONS
Further investigation is needed to ascertain the association between LABD, VCM, and heart disease.
Coimbra University Hospital, Coimbra.
Ana
A
Gameiro
Miguel
M
Gouveia
Oscar
O
Tellechea
Margarida
M
Goncalo
D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D005148:Facial Dermatoses / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D007868:Leg Dermatoses / Q000139:chemically induced* / Q000473:pathology; D062027:Linear IgA Bullous Dermatosis / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D014640:Vancomycin / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D014640:Vancomycin