title: Linear immunoglobulin A dermatosis mimicking toxic epidermal necrolysis: a case report of etanercept treatment.
abstract: A 65-year-old pluripathological woman attended our hospital with a cutaneous eruption of sudden appearance after vancomycin treatment. She presented targetoid lesions affecting approximately 25-30% of her body surface, large erosions with mucosal lesions and positive Nikolsky sign. Under the initial clinical suspicion of toxic epidermal necrolysis (TEN), and considering the recent literature of successful use of etanercept in these cases, she was treated with a single dose of this antitumour necrosis factor (anti-TNF) agent. Subsequently, the exanthema progression stopped and resolution of the lesions happened in a few days. Later on, histopathology revealed a subepidermal blister with dense neutrophilic infiltrate and linear deposits of immunoglobulin A (IgA) on the dermoepidermal junction, allowing us to establish the diagnosis of drug-induced linear IgA dermatosis mimicking TEN. Linear IgA dermatosis can have severe clinical manifestations, even mimicking TEN, and can have high mortality, especially in drug-induced cases. We have not found any other report of linear IgA dermatosis treated with etanercept in the English literature. Anti-TNF medications could represent useful therapeutic alternatives in this dermatosis.
authors.affiliation: Departments of Dermatology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Prieto-Barrios
authors.affiliation: Departments of Dermatology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Velasco-Tamariz
authors.affiliation: Departments of Dermatology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Tous-Romero
authors.affiliation: Departments of Dermatology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Burillo-Martinez
authors.affiliation: Departments of Dermatology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Zarco-Olivo
authors.affiliation: Departments of Pathology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Rodriguez-Peralto
authors.affiliation: Departments of Dermatology, Hospital Universitario 12 de Octubre, I + 12 Research Institute, Universidad Complutense, Madrid, Spain.
authors.forename: P L
authors.initials: PL
authors.lastname: Ortiz-Romero
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D003879:Dermatologic Agents / Q000627:therapeutic use*; D003937:Diagnosis, Differential; D000068800:Etanercept / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D062027:Linear IgA Bullous Dermatosis / Q000175:diagnosis* / Q000188:drug therapy; D013262:Stevens-Johnson Syndrome / Q000175:diagnosis* / Q000188:drug therapy; D016896:Treatment Outcome; D014640:Vancomycin / Q000009:adverse effects
chemical_list: D000900:Anti-Bacterial Agents; D003879:Dermatologic Agents; D014640:Vancomycin; D000068800:Etanercept