Abstract
Pemphigus comprises a group of autoimmune bullous diseases characterized by acantholysis (loss of adhesion between keratinocytes) that results in the formation of intraepithelial blisters in the skin and mucous membranes. Multiple drugs are reported to induce pemphigus, most commonly thiol drugs. The mechanisms include autoantibody formation and direct acantholysis. The diagnosis of drug-induced pemphigus is challenging. Patients are often on multiple medications, and the latency period between exposure and onset of disease can be variable. Withdrawal of an offending drug may lead to remission or reduced disease severity in many patients.
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Abbreviations
- HLA:
-
Human leukocyte antigen
- IL-1:
-
Interleukin-1
- TNF-α:
-
Tumor necrosis factor alpha
References
Brenner S, Bialy-Golan A, Ruocco V. Drug-induced pemphigus. Clin Dermatol. 1998;16(3):393–7.
Goldberg I, Shirazi I, Brenner S. In vitro interferon-gamma release test in patients with drug-induced pemphigus. Isr Med Assoc J. 2008;10(6):424–7.
Harman KE, Brown D, Exton LS, Groves RW, Hampton PJ, Mohd Mustapa MF, Setterfield JF, Yesudian PD. British Association of Dermatologists’ guidelines for the management of pemphigus vulgaris. Br J Dermatol. 2017;177:1170–201.
Joly P, Horvath B, Patsatsi Α, Uzun S, Bech R, et al. Updated S2K guidelines on the management of pemphigus vulgaris and foliaceus initiated by the european academy of dermatology and venereology (EADV). J Eur Acad Dermatol Venereol. 2020;34:1900–13.
Maruani A, Machet MC, Carlotti A, et al. Immunostaining with antibodies to desmoglein provides the diagnosis of drug-induced pemphigus and allows prediction of outcome. Am J Clin Pathol. 2008;130(3):369–74.
Nagao K, Tanikawa A, Yamamoto N, Amagai M. Decline of anti-desmoglein 1 IgG ELISA scores by withdrawal of D-penicillamine in drug-induced pemphigus foliaceus. Clin Exp Dermatol. 2005;30(1):43–5.
Pile HD, Yarrarapu SNS, Crane JS. Drug induced pemphigus. [Updated 2020 Jul 20]. In: StatPearls [Internet]. Treasure Island, FL: StatPearls Publishing; 2020. https://www.ncbi.nlm.nih.gov/books/NBK499864/
Ruocco V, Pisani M. Induced pemphigus. Arch Dermatol Res. 1982;274:123–40.
Saito Y, Hayashi S, Yamauchi A, et al. Tracing the origins of active amide group-positive drug-induced pemphigus vulgaris along the silk road: a case report of candesartan-induced pemphigus vulgaris and review of nonthiol drug-induced pemphigus. Int J Dermatol. 2018;57(11):e131–4.
Tang X, Zhang X. Drug-induced pemphigus after six years of treatment with phenytoin and carbamazepine. Int J Dermatol. 2012;51(4):485–6.
Tavakolpour S. Pemphigus trigger factors: special focus on pemphigus vulgaris and pemphigus foliaceus. Arch Dermatol Res. 2018;310(2):95–106.
Yamamoto T, Takata-Michigami M, Hisamatsu Y, et al. A prospective analysis of anti-desmoglein antibody profiles in patients with rheumatoid arthritis treated with thiol compounds. J Dermatol Sci. 2010;59(3):170–5.
Further Reading
Bae YI, Yun SJ, Lee SC, et al. Pemphigus foliaceus induced by an angiotensin II receptor blocker. Clin Exp Dermatol. 2008;33(6):721–3.
Brenner S, Bialy-Golan A, Anhalt GJ. Recognition of pemphigus antigens in drug-induced pemphigus vulgaris and pemphigus foliaceus. J Am Acad Dermatol. 1997;36(6 Pt 1):919–23.
Brenner S, Ruocco V, Ruocco E, et al. A possible mechanism for phenol-induced pemphigus. Skinmed. 2006;5(1):25–6.
Feng S, Zhou W, Zhang J, Jin P. Analysis of 6 cases of drug-induced pemphigus. Eur J Dermatol. 2011;21(5):696–9.
Goldberg I, Sasson A, Gat A, et al. Pemphigus vulgaris triggered by glibenclamide and cilazapril. Acta Dermatovenerol Croat. 2005;13(3):153–5.
Landau M, Brenner S. Histopathologic findings in drug-induced pemphigus. Am J Dermatopathol. 1997;19(4):411–4.
Marsden RA, Vanhegan RI, Walshe M, et al. Pemphigus foliaceus induced by penicillamine. Br Med J. 1976;2(6049):1423–4.
Matzner Y, Erlich HA, Brautbar C. Identical HLA class II alleles predispose to drug-triggered and idiopathic pemphigus vulgaris. Acta Derm Venereol. 1995;75(1):12–4.
Ruocco V, De Angelis E, Lombardi ML. Drug-induced pemphigus. II. Pathomechanisms and experimental investigations. Clin Dermatol. 1993;11:507–13.
Wolf R, Tamir A, Brenner S. Drug-induced versus drug-triggered pemphigus. Dermatologica. 1991;182(4):207–10.
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Mahmood, N.F., Al-Haddabi, A., Gnanappiragasam, D., Golberg, O., Harman, K.E. (2023). Drug-Induced Pemphigus. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_70
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