Skip to main content

Abstract

Pemphigus comprises a group of autoimmune bullous diseases characterized by acantholysis (loss of adhesion between keratinocytes) that results in the formation of intraepithelial blisters in skin and mucous membranes. Drug-induced pemphigus (DIP) is a rare but well-established type of pemphigus, Multiple drugs are reported to induce pemphigus, most commonly thiol drugs. The mechanisms include autoantibody formation and direct acantholysis. Withdrawal of an offending drug may lead to remission or reduced disease severity in many patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 219.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 279.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Abbreviations

HLA:

Human leukocyte antigen

IL-1:

Interleukin-1

TNF-α:

Tumour necrosis factor alpha

References

  • Brenner S, Bialy-Golan A, Ruocco V. Drug-induced pemphigus. Clin Dermatol. 1998;16(3):393–7.

    Article  CAS  Google Scholar 

  • Chams-Davatchi C, Esmaili N, Daneshpazhooh M, et al. Randomized controlled open-label trial of four treatment regimens for pemphigus vulgaris. J Am Acad Dermatol. 2007;57(4):622.

    Article  Google Scholar 

  • Goldberg I, Shirazi I, Brenner S. In vitro interferon-gamma release test in patients with drug-induced pemphigus. Isr Med Assoc J. 2008;10(6):424–7.

    PubMed  Google Scholar 

  • Ioannides D, Apalla Z, Lazaridou E, Rigopoulos D. Evaluation of mycophenolate mofetil as a steroid-sparing agent in pemphigus: a randomized, prospective study. J Eur Acad Dermatol Venereol. 2012;26(7):855–60.

    Article  CAS  Google Scholar 

  • Maruani A, Machet MC, Carlotti A, et al. Immunostaining with antibodies to desmoglein provides the diagnosis of drug-induced pemphigus and allows prediction of outcome. Am J Clin Pathol. 2008;130(3):369–74.

    Article  Google Scholar 

  • Nagao K, Tanikawa A, Yamamoto N, Amagai M. Decline of anti-desmoglein 1 IgG ELISA scores by withdrawal of D-penicillamine in drug-induced pemphigus foliaceus. Clin Exp Dermatol. 2005;30(1):43–5.

    Article  CAS  Google Scholar 

  • Tang X, Zhang X. Drug-induced pemphigus after six years of treatment with phenytoin and carbamazepine. Int J Dermatol. 2012;51(4):485–6.

    Article  Google Scholar 

  • Yamamoto T, Takata-Michigami M, Hisamatsu Y, et al. A prospective analysis of anti-desmoglein antibody profiles in patients with rheumatoid arthritis treated with thiol compounds. J Dermatol Sci. 2010;59(3):170–5.

    Article  CAS  Google Scholar 

Further Reading

  • Amagai M, Ikeda S, Shimizu H, et al. A randomized double-blind trial of intravenous immunoglobulin for pemphigus. J Am Acad Dermatol. 2009;60(4):595–603.

    Article  Google Scholar 

  • Bae YI, Yun SJ, Lee SC, et al. Pemphigus foliaceus induced by an angiotensin II receptor blocker. Clin Exp Dermatol. 2008;33(6):721–3.

    Article  CAS  Google Scholar 

  • Beissert S, Mimouni D, Kanwar AJ, et al. Treating pemphigus vulgaris with prednisone and mycophenolate mofetil: a multicenter, randomized, placebo-controlled trial. J Invest Dermatol. 2010;130(8):2041.

    Article  CAS  Google Scholar 

  • Brenner S, Bialy-Golan A, Anhalt GJ. Recognition of pemphigus antigens in drug-induced pemphigus vulgaris and pemphigus foliaceus. J Am Acad Dermatol. 1997;36(6 Pt 1):919–23.

    Article  CAS  Google Scholar 

  • Brenner S, Ruocco V, Ruocco E, et al. A possible mechanism for phenol-induced pemphigus. Skinmed. 2006;5(1):25–6.

    Article  Google Scholar 

  • Feng S, Zhou W, Zhang J, Jin P. Analysis of 6 cases of drug-induced pemphigus. Eur J Dermatol. 2011;21(5):696–9.

    CAS  PubMed  Google Scholar 

  • Goldberg I, Sasson A, Gat A, et al. Pemphigus vulgaris triggered by glibenclamide and cilazapril. Acta Dermatovenerol Croat. 2005;13(3):153–5.

    PubMed  Google Scholar 

  • Gurcan HM, Keskin DB, Stern JN, et al. A review of the current use of rituximab in autoimmune diseases. Int Immunopharmacol. 2009;9:10–25.

    Article  Google Scholar 

  • Harman KE, Albert S, Black MM. Guidelines for the management of pemphigus vulgaris. Br J Dermatol. 2003;149(5):926–37.

    Article  CAS  Google Scholar 

  • Horváth B, Huizinga J, Pas HH, et al. Low-dose rituximab is effective in pemphigus. Br J Dermatol. 2012;166(2):405–12.

    Article  Google Scholar 

  • Kasperkiewicz M, Shimanovich I, Meier M, et al. Treatment of severe pemphigus with a combination of immunoadsorption, rituximab, pulsed dexamethasone and azathioprine/mycophenolate mofetil: a pilot study of 23 patients. Br J Dermatol. 2012;166(1):154–60.

    Article  CAS  Google Scholar 

  • Landau M, Brenner S. Histopathologic findings in drug-induced pemphigus. Am J Dermatopathol. 1997;19(4):411–4.

    Article  CAS  Google Scholar 

  • Marsden RA, Vanhegan RI, Walshe M, et al. Pemphigus foliaceus induced by penicillamine. Br Med J. 1976;2(6049):1423–4.

    Article  CAS  Google Scholar 

  • Matzner Y, Erlich HA, Brautbar C. Identical HLA class II alleles predispose to drug-triggered and idiopathic pemphigus vulgaris. Acta Derm Venereol. 1995;75(1):12–4.

    CAS  PubMed  Google Scholar 

  • Pasricha JS. Poonam. Current regimen of pulse therapy for pemphigus: minor modifications, improved results. Indian J Dermatol Venereol Leprol. 2008;74:217–21.

    Article  CAS  Google Scholar 

  • Ruocco V, De Angelis E, Lombardi ML. Drug-induced pemphigus. II. Pathomechanisms and experimental investigations. Clin Dermatol. 1993;11:507–13.

    Article  CAS  Google Scholar 

  • Wolf R, Tamir A, Brenner S. Drug-induced versus drug-triggered pemphigus. Dermatologica. 1991;182(4):207–10.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Golberg, O., Harman, K.E. (2015). Drug-Induced Pemphigus. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D’Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45139-7_72

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-45139-7_72

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-45138-0

  • Online ISBN: 978-3-662-45139-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics