Linear Immunoglobulin A Bullous Dermatosis: Need for an Agreement on Diagnostic Criteria

Antiga, Emiliano; Caproni, Marzia; Fabbri, Paolo

doi:10.1159/000350818

Cited by 41 publications

(55 citation statements)

References 22 publications

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“…Adult onset varies from 14 to 80 years, most commonly autoimmune on the younger and drug-induced disease in the elderly 9. Typical skin manifestations include multiple vesicles, blisters and erythema erosions along the extensor surfaces and torso.…”

Section: Discussionmentioning

confidence: 99%

“…Gluten sensitivity has not been associated with LAD. Evidenced-based guidelines for management of bullous skin lesions associated to LAD or bullous pemphigoid suggests no gold standard treatment 9. However, pharmacological treatment with systemic corticosteroids should be considered first, with doxycycline, dapsone, nicotinamide, azathioprine or sulfapyridine for mild to moderate disease 10.…”

Section: Introductionmentioning

confidence: 99%

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Previously misdiagnosed linear IgA dermatosis resolved with dapsone

Francio¹,

Towery

Davani

et al. 2018

BMJ Case Reports

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This is the case of a 25-year-old African American woman with a 3-week history of itching with burning, blistering lesions on her torso and extremities. Medical history was unremarkable. Medical treatments included three visits to urgent care, where she was treated with antivirals, oral and topical steroids, antibiotics and antifungals unsuccessfully. We performed a skin biopsy, and immunoflorescent studies revealed a linear deposition of IgA antigen at the basement membrane. The clinical diagnosis of linear IgA dermatosis (LAD) was established, with no eliciting cause, other than potential occupational exposure to via her employment in a pet store. This is the first case to our knowledge to report such an association. However, confirmation of the exposure would only establish correlation, not causality. Resolution of symptoms and blisters was achieved with dapsone treatment. Accordingly, we highlight the crucial importance of reviewing exposures, along with the potential aetiology of LAD.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Previously misdiagnosed linear IgA dermatosis resolved with dapsone

Francio¹,

Towery

Davani

et al. 2018

BMJ Case Reports

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“…Our patient presented here has history of dilated cardiomyopathy and aortic insufficiency. Further investigation is needed to ascertain the association between LABD, vancomycin, and heart disease [5, 7]. Lesions develop within 24 hours to 15 days after the first dose of vancomycin and new lesions usually cease to appear within one to three days after discontinuation of drug [1, 3, 8, 9].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis

Jha

Swanson

Stromich

et al. 2017

Case Reports in Dermatological Medicine

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Linear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister) formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations.

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“…The etiology of LABD is not fully understood and international accepted diagnostic criteria are lacking [1]. However, diagnosis is mainly based on a combination of clinical, histopathological and immunologic parameters.…”

Section: Introductionmentioning

confidence: 99%