Vancomycin-induced linear IgA bullous dermatosis with isomorphic response

Circular Erythematous Plaque at the Area of Median Sternotomy

“…Typical cutaneous manifestations include tense arciform bullae in a cluster-of-jewels configuration or, less commonly, grouped papulovesicles . Atypical lesions owing to Koebner phenomenon have also been reported in areas where adhesives were previously applied . This patient developed a lesion on the median sternotomy scar, which was highly suggestive of koebnerization.…”

“…5,6 Atypical lesions owing to Koebner phenomenon have also been reported in areas where adhesives were previously applied. 7,8 This patient developed a lesion on the median sternotomy scar, which was highly suggestive of koebnerization. Although isomorphic response on operation scars has been described in other bullous dermatoses, to our knowledge, only 1 case has been described in LAD.…”

“…Although isomorphic response on operation scars has been described in other bullous dermatoses, to our knowledge, only 1 case has been described in LAD. 8 The histopathologic features are represented by the presence of subepidermal bullae with neutrophil-predominant infiltrate at the dermal-epidermal junction, which are characteristically arranged in a linear array. 1,9 The criterion standard for establishing an LAD diagnosis is DIF revealing linear IgA antibody deposition along the basement membrane.…”

An array of unusual clinical features in a woman with amlodipine-induced linear immunoglobulin A disease

“…This has been seldom seen in LAD. Document VCM-induced LAD cases show occurrences of koebnerization at sites of adhesive placement on the skin (McDonald et al, 2010) and scar sites of cardiac surgery on the abdomen (Mori and Yamamoto, 2013), but metronidazole and hyoscine-N-butylbromide-induced LAD had evidence of koebnerization as reported in one case (Rashid Dar and Raza, 2008).…”

“…Our findings are consistent with those of previously reported cases in the literature, and strengthen this association. Among various hypotheses, one is that traumatized epidermis may express antigens or expose new epitopes (Mori and Yamamoto, 2013). Another hypothesis is that the development of new lesions could be due to increased blood flow in areas of scratching due to trauma and friction, thus bringing in more auto-antibodies to the site (Rashid Dar and Raza, 2008).…”