Vancomycin-induced Linear IgA Bullous Dermatosis: A Case Report and Review of the Literature

Kang, Min Ju; Kim, Hyung Ok; Park, Young Min

doi:10.5021/ad.2008.20.2.102

Cited by 14 publications

(12 citation statements)

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“…Treatment is usually discontinuing the drug. Medications, including dapsone and high-potency topical steroids (such as clobetasol or betamethasone), are the first-line agents [4-7]. However, colchicine can be used if patients are unable to tolerate dapsone.…”

Section: Discussionmentioning

confidence: 99%

Linear IgA Disease: A Rare Complication of Vancomycin

Saleem¹,

Iftikhar²

2019

Cureus

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Linear immunoglobulin A (IgA) bullous dermatosis, also known as linear IgA disease, is a rare disorder with an incidence of about 0.5 to 2.3 cases per million individuals per year. In most of the cases, the cause is unknown; however, 50% of the cases are drug-induced. The disease has bimodal age predilection and occurs in children up to the age of 10 years and in adults usually after the age of 60 years. Common drugs that have been known to cause this disease include vancomycin, lithium, amiodarone, captopril, and some of the nonsteroidal anti-inflammatory agents. We report a case of linear IgA disease secondary to vancomycin.

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Section: Discussionmentioning

confidence: 99%

Linear IgA Disease: A Rare Complication of Vancomycin

Saleem¹,

Iftikhar²

2019

Cureus

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“…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]. Lesions vary in nature ranging from tense serous/hemorrhagic bulla (blister), string of pearl “herpetiform” configurations to targetoid/erythema multiforme-like eruptions.…”

Section: Discussionmentioning

confidence: 99%

“…Polymorphous clinical and immunopathologic features of this dermatosis can be partially explained by the different target antigens identified on Western blotting, including collagen type VII and the 97 kDa and 230 kDa antigens [2, 4, 5, 9, 12]. One study reported two cases of vancomycin-induced LABD with autoantibodies against BP180 and LAD 285 [5, 9, 11].…”

Section: Discussionmentioning

confidence: 99%

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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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“…Vancomycin is regarded as one of the most common causes of drug‐induced LABD with perilesional biopsy specimens frequently demonstrating the characteristic linear IgA deposition on DIF . In the vast majority of these cases indirect immunofluorescence remains negative.…”

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confidence: 99%