Abstract
Drug-induced bullous disorders encompass a diverse array of clinical presentations determined by the pathology at the dermal/epidermal junction. These include bullous pemphigoid, dermatitis herpetiformis, linear IgA, and pemphigus variants. Fluid-filled blisters encompass all drug-induced bullous disorders after a latency period; however, other clinical features including mucosal involvement can vary.
In linear IgA bullous dermatosis, vancomycin is the most common offending agent. Pemphigus variants, including vulgaris and foliaceus, often present after the use of thiol, phenol, and non-thiol containing drugs. More than 50 different drugs have been associated with the onset of bullous pemphigoid, with thiols being a major group tied to drug-induced bullous pemphigoid. A few cases of drug-induced dermatitis herpetiformis have been reported in the literature. Most of these cases involve hormone-modulating or immunomodulating drugs.
Overall, drug-induced bullous dermatoses respond rapidly to cessation of the offending agent and corticosteroid therapy. It is therefore important to always have clinical suspicion for the drug-induced form of autoimmune bullous dermatoses.
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Stafford, M.A., Patel, S.S., Boyers, L.N., Karimkhani, C. (2015). Autoimmune Bullous Diseases and Drugs. In: Hall, J., Hall, B. (eds) Cutaneous Drug Eruptions. Springer, London. https://doi.org/10.1007/978-1-4471-6729-7_18
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