Chronic bullous disease of childhood following Epstein-Barr virus seroconversion: a case report

Baldari, U; Raccagni, Antonio Ascari; Celli, Barbara; Righini, Maria Giovanna

doi:10.1111/j.1365-2230.1996.tb00034.x

Cited by 24 publications

(9 citation statements)

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“…Idiopathic LABD related to previous infections has been reported, many of these being respiratory virus‐related respiratory diseases 5 . In the literature we found a case reporting a chronic bullous disease of childhood following Epstein‐Barr virus (EBV) seroconversion 6 . In our patient an EBV infection was diagnosed after 7 days.…”

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confidence: 59%

Amoxicillin‐associated linear IgA bullous dermatosis

Santos‐Juanes¹,

Hernández

Trapiella

et al. 2007

Acad Dermatol Venereol

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EditorLinear IgA bullous dermatosis (LABD) is an uncommon autoimmune subepidermal blistering disease characterized by linear deposition of IgA along the basement membrane. Although the majority of cases are idiopathic, some cases are described as drug-induced, especially with vancomycin. In addition to vancomycin, LABD can be induced by other antibiotics such as rifampicin, G penicillin, and secondgeneration cephalosporins, metronidazol, and trimetropin sulfametoxazol. 1-4 To our knowledge none has been reported as being induced by amoxicillin.A 62-old-year woman was admitted as a result of generalized pruriginous eruption that started 24 h after beginning treatment with amoxicillin for high temperature and odinophagia and adenopathies. We do not know whether the patient had previously received amoxicillin. Exploration showed erythematous, papules on the trunk and proximal extremities. Mucous membranes, palms and soles were not involved. Over the next 48 h the lesions spread to become vesicles and bullae on the neck, trunk and feet. In the complementary studies the haemogram was normal, except for small leucocytosis and neutrophilia. The biochemical studies showed a slight increase of transaminases and acute phase reactants. A biopsy of one of the bullae was performed and revealed a subepidermal blister with predominantly neutrophilic cells. Direct immunofluorescence revealed linear deposits of IgA at the basement membrane zone and the diagnosis was consistent with LABD. On day 7 the patient was disorientated and as a result an examination of the spinal cord fluid was per-formed. This revealed lymphocytic meningitis (95% cells, 80% mononuclear cells). An Epstein-Barr polymerase chain reaction (PCR) from cerebrospinal fluid was positive. The patient received treatment with acyclovir and steroids and improved rapidly from a neurological point of view.Dermatological lesions improved considerably and disappeared without sequelae. An Epstein-Barr PCR from the skin lesions was negative.Our patient presented the clinical characteristics of LABD, induced by the ingestion of amoxicillin, and this appeared between 1 and 15 days after starting the drug. 3 Idiopathic LABD related to previous infections has been reported, many of these being respiratory virus-related respiratory diseases. 5 In the literature we found a case reporting a chronic bullous disease of childhood following Epstein-Barr virus (EBV) seroconversion. 6 In our patient an EBV infection was diagnosed after 7 days. In EBV infections up to 10% of the cases present cutaneous lesions such as macular or maculopapular exanthems, petechiae, morbilliform and scarlatiniform eruptions, or acute urticaria.The administration of amoxicillin in the context of EBV infection induces a pruriginous maculopapular eruption in 90 -100% of patients, but bullae have not been described. We do not know the pathogenic role of EBV in our patient. We believe that the virus was not directly responsible because the skin PCR was negative, but we do not know whether EBV was coadjuvant or ...

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confidence: 59%

Amoxicillin‐associated linear IgA bullous dermatosis

Santos‐Juanes¹,

Hernández

Trapiella

et al. 2007

Acad Dermatol Venereol

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“…Different infections such as Salmonella enteritis, nonspecific gastrointestinal infection, and Epstein-Barr virus infection have been associated with linear IgA bullous dermatosis of childhood. [28][29][30] Interestingly, in the report of Salmonella enteritis, the patient had been started on flucloxacillin before developing linear IgA bullous dermatosis of childhood. It is not clear whether the development of this immunobullous eruption is related to the infection, the treatment, both, or neither.…”

Section: Discussionmentioning

confidence: 99%

Treatment of linear IgA bullous dermatosis of childhood with flucloxacillin

Alajlan¹,

Al-Khawajah²,

Al-Sheikh³

et al. 2006

Journal of the American Academy of Dermatology

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“…Vancomycin is the most commonly implicated drug. 3 In addition, associations with lymphoproliferative disorders, 4,5 infections, 6,7 ulcerative colitis, 8 and systemic lupus erythematosis 9 have been reported.…”

Section: What Is the Prognosis? Discussionmentioning

confidence: 99%