Pemphigus triggered by diclofenac

Pellicano, R.; Iannantuono, Marco; Ciommo, Antonio Di; Bisceglia, Michele

doi:10.1016/0926-9959(96)00063-3

Journal of the European Academy of Dermatology and Venereology

1996

DOI: 10.1016/0926-9959(96)00063-3

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Pemphigus triggered by diclofenac

R. Pellicano

Marco Iannantuono

Antonio Di Ciommo

et al.

Abstract: We report a case of pemphigus vulgaris which first appeared in a young Italian male during treatment with diclofenac. The initial lesions persisted for 5 months after the drtig was discontintjcd and later worsened when the patient was treated wilh piroxicam. HLA typing revealed the presence of 3 antigen.s which have been shown to be associated with pemphigus (B55, DR6. DQl). This appears to be the first report of petiiphigus vulgaris triggered by diclofenac.

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2008

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“…There are sporadic cases of pemphigus associated with the use of drugs, the majority of them with drugs containing thiol grups (penicillamine or captopril) or that release thiol grups during their metabolism (piroxicam, pyritinol). Other drugs such as nifedipine, rifampicine or phenobarbital have also been implicated 1 …”

mentioning

confidence: 99%

Pemphigus vulgaris associated with cocaine snorting

Laguna¹,

Sánchez‐Carazo

Pérez‐Ferriols

et al. 2008

Acad Dermatol Venereol

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relationship with the tattooed area. Thus, in fact, we think that the cellulitis and impetigo were a consequence and not a cause of the traumatized vasculitic lesions.Another observation that we would like to point out is the fact that regrettably, in our country, most of the places where people get tattooed are not licensed for that purpose, and there is a lack of control over the materials employed. Therefore, the inks used for tattooing still contain selenium, codenium and cinabrium, which elicit so many chronic granulomatous or lichenoid reactions. 1,2 These are often represented by erythematous papules that localize over the red ink. 3,4 Physiopathologically, these kinds of lesions are delayed-type hypersensitivity cellular reactions (Gell and Coombs Type IV), whereas vasculitis is an antibody-mediated systemic process, explaining the lack of restriction of the lesions to the tattooed area. 5,6 The treatment for the former is long and disappointing, and it is corticosteroid based. 7 On the other hand, hypersensitivity vasculitic reactions present an acute or subacute course and often respond to low-intermediate dose of prednisone and require no further intervention once the process is over. 8 We strongly discourage the intradermal provocation test because vasculitis is a systemic reaction, and the test carries a possible risk for the patient.Finally, the coincidence of tattooing and leukocytoclastic vasculitis of some other origin would be highly improbable. Nevertheless, we performed complete lab tests to rule out viral infections and collagen diseases among others. 9 Of course, infection represents a powerful cause of leukocytoclastic vasculitis, but in this case, the chronology of the events suggest otherwise. Unfortunately, there is no test available that can confirm the ethiological relationship between the colorants and the vasculitic lesions, but we think that there is enough clinical evidence to assume that among the materials used in the procedure is the stimulus that triggered the reported reaction. References1 Martín JM, Revert A, Alonso V et al. [Acute contact eczema from paraphenylenediamine contained in temporary henna tattoos]. Actas Dermosifiliogr 2005; 96: 382-385. 2 Matulich J, Sullivan J. A temporary henna tattoo causing hair and clothing dye allergy. Contact Dermatitis 2005; 53: 33-36. 3 Malvido KA, Foster Fernández J, Stengel FM, Cabrera HN. Reacciones de hipersensibilidad sobre tatuaje. Presentación de cinco casos. Arch Argent Dermatol 2001; 51: 273-280. 4 Mortimer NJ, Chave TA, Johston GA. Red tattoo reactions. Clin Exp Dermatol 2003; 28: 508-510. 5 Chave TA, Mortimer NJ, Johnston GA. Simultaneous pseudolymphomatous and lichenoid tattoo reactions triggered by re-tattooing. EditorThere are sporadic cases of pemphigus associated with the use of drugs, the majority of them with drugs containing thiol grups (penicillamine or captopril) or that release thiol grups during their metabolism (piroxicam, pyritinol). Other drugs such as nifedipine, rifampicine or phenobarbital have also been impl...

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mentioning

confidence: 99%

Pemphigus vulgaris associated with cocaine snorting

Laguna¹,

Sánchez‐Carazo

Pérez‐Ferriols

et al. 2008

Acad Dermatol Venereol

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Pemphigus triggered by diclofenac

Cited by 1 publication

References 13 publications

Pemphigus vulgaris associated with cocaine snorting

Pemphigus vulgaris associated with cocaine snorting

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