title: Piperacillin-tazobactam-induced linear IgA bullous dermatosis presenting clinically as Stevens-Johnson syndrome/toxic epidermal necrolysis overlap.
abstract: Linear IgA bullous dermatosis (LABD) is a subepidermal autoimmune bullous disease characterized by linear IgA deposition at the basement membrane zone, which is visualized by direct immunofluorescence. Patients with LABD typically present with widespread vesicles and bullae; however, this is not necessarily the case, as the clinical presentation of this disease is heterogeneous. LABD clinically presenting as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) is an infrequent, yet well-described phenomenon. Most cases of LABD are idiopathic, but some cases are drug-induced. Multiple drugs have been implicated in the development of LABD. We report a case of piperacillin-tazobactam-induced LABD presenting clinically as SJS/TEN overlap. This is the first reported case of a strong causal association between piperacillin-tazobactam and the development of LABD.
authors.affiliation: Department of General Medicine, Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: N R
authors.initials: NR
authors.lastname: Adler
authors.affiliation: Department of Anatomical Pathology, Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: C A
authors.initials: CA
authors.lastname: McLean
authors.affiliation: Department of General Medicine, Alfred Hospital, Melbourne, VIC, Australia.|Department of Infectious Diseases, Alfred Hospital, Melbourne, VIC, Australia.|Monash University, Melbourne, VIC, Australia.
authors.forename: A K
authors.initials: AK
authors.lastname: Aung
authors.affiliation: Department of Dermatology, Alfred Hospital, Melbourne, VIC, Australia.
authors.forename: M S Y
authors.initials: MS
authors.lastname: Goh
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003937:Diagnosis, Differential; D006801:Humans; D062027:Linear IgA Bullous Dermatosis / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D010397:Penicillanic Acid / Q000009:adverse effects / Q000031:analogs & derivatives*; D010878:Piperacillin / Q000009:adverse effects; D000077725:Piperacillin, Tazobactam Drug Combination; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis*
chemical_list: D000900:Anti-Bacterial Agents; D000077725:Piperacillin, Tazobactam Drug Combination; D010397:Penicillanic Acid; D010878:Piperacillin