Advertisement

Drug-Induced Pemphigus

  • Olga Golberg
  • Karen Elizabeth Harman

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 skin and mucous membranes. Drug-induced pemphigus (DIP) is a rare but well-established type of pemphigus, Multiple drugs are reported to induce pemphigus, most commonly thiol drugs. The mechanisms include autoantibody formation and direct acantholysis. Withdrawal of an offending drug may lead to remission or reduced disease severity in many patients.

Keywords

Drug-induced pemphigus Thiol drugs Acantholysis Anti-desmoglein antibodies 

Abbreviations

HLA

Human leukocyte antigen

IL-1

Interleukin-1

TNF-α

Tumour necrosis factor alpha

References

  1. Brenner S, Bialy-Golan A, Ruocco V. Drug-induced pemphigus. Clin Dermatol. 1998;16(3):393–7.PubMedGoogle Scholar
  2. Chams-Davatchi C, Esmaili N, Daneshpazhooh M, et al. Randomized controlled open-label trial of four treatment regimens for pemphigus vulgaris. J Am Acad Dermatol. 2007;57(4):622.PubMedGoogle Scholar
  3. 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.PubMedGoogle Scholar
  4. Ioannides D, Apalla Z, Lazaridou E, Rigopoulos D. Evaluation of mycophenolate mofetil as a steroid-sparing agent in pemphigus: a randomized, prospective study. J Eur Acad Dermatol Venereol. 2012;26(7):855–60.PubMedGoogle Scholar
  5. 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.PubMedGoogle Scholar
  6. 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.PubMedGoogle Scholar
  7. Tang X, Zhang X. Drug-induced pemphigus after six years of treatment with phenytoin and carbamazepine. Int J Dermatol. 2012;51(4):485–6.PubMedGoogle Scholar
  8. 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.PubMedGoogle Scholar

Further Reading

  1. Amagai M, Ikeda S, Shimizu H, et al. A randomized double-blind trial of intravenous immunoglobulin for pemphigus. J Am Acad Dermatol. 2009;60(4):595–603.PubMedGoogle Scholar
  2. 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.PubMedGoogle Scholar
  3. Beissert S, Mimouni D, Kanwar AJ, et al. Treating pemphigus vulgaris with prednisone and mycophenolate mofetil: a multicenter, randomized, placebo-controlled trial. J Invest Dermatol. 2010;130(8):2041.PubMedGoogle Scholar
  4. 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.PubMedGoogle Scholar
  5. Brenner S, Ruocco V, Ruocco E, et al. A possible mechanism for phenol-induced pemphigus. Skinmed. 2006;5(1):25–6.PubMedGoogle Scholar
  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.PubMedGoogle Scholar
  7. Goldberg I, Sasson A, Gat A, et al. Pemphigus vulgaris triggered by glibenclamide and cilazapril. Acta Dermatovenerol Croat. 2005;13(3):153–5.PubMedGoogle Scholar
  8. Gurcan HM, Keskin DB, Stern JN, et al. A review of the current use of rituximab in autoimmune diseases. Int Immunopharmacol. 2009;9:10–25.PubMedGoogle Scholar
  9. Harman KE, Albert S, Black MM. Guidelines for the management of pemphigus vulgaris. Br J Dermatol. 2003;149(5):926–37.PubMedGoogle Scholar
  10. Horváth B, Huizinga J, Pas HH, et al. Low-dose rituximab is effective in pemphigus. Br J Dermatol. 2012;166(2):405–12.PubMedGoogle Scholar
  11. Kasperkiewicz M, Shimanovich I, Meier M, et al. Treatment of severe pemphigus with a combination of immunoadsorption, rituximab, pulsed dexamethasone and azathioprine/mycophenolate mofetil: a pilot study of 23 patients. Br J Dermatol. 2012;166(1):154–60.PubMedGoogle Scholar
  12. Landau M, Brenner S. Histopathologic findings in drug-induced pemphigus. Am J Dermatopathol. 1997;19(4):411–4.PubMedGoogle Scholar
  13. Marsden RA, Vanhegan RI, Walshe M, et al. Pemphigus foliaceus induced by penicillamine. Br Med J. 1976;2(6049):1423–4.PubMedPubMedCentralGoogle Scholar
  14. 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.PubMedGoogle Scholar
  15. Pasricha JS. Poonam. Current regimen of pulse therapy for pemphigus: minor modifications, improved results. Indian J Dermatol Venereol Leprol. 2008;74:217–21.PubMedGoogle Scholar
  16. Ruocco V, De Angelis E, Lombardi ML. Drug-induced pemphigus. II. Pathomechanisms and experimental investigations. Clin Dermatol. 1993;11:507–13.PubMedGoogle Scholar
  17. Wolf R, Tamir A, Brenner S. Drug-induced versus drug-triggered pemphigus. Dermatologica. 1991;182(4):207–10.PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Olga Golberg
    • 1
  • Karen Elizabeth Harman
    • 1
  1. 1.University HospitalsLeicesterUK

Personalised recommendations