Clinical,histopathological and immunological profiles in 14 patients with drug-induced pemphigus studied in Kurume University
Kazuhiro YoshimuraNorito IshiiTakahiro HamadaToshifumi AbeFumikake OnoKeiko HashikawaShunpei FukudaBungo OhyamaHiroshi KogaRyousuke SogameTadashi KarashimaTakekuni NakamaTeruki DainichiDaisuke TsurutaTakashi Hashimoto
摘要：<正>Background Drug-induced pemphigus（DIP） shows variable features.This study aimed to characterize clinical, histopathological and immunological features in 14 DIP patients. Methods We characterized DIP patients for clinical and histopathological manifestations and responsible drugs,and performed immunofluorescence,enzyme-linked immunosorbent assay（ELISA） and immunoblot studies. Results Ten of the 14 DIP patients showed pemphigus foliaceus-like appearance,two showed pemphigus herpetiformis-like appearance,and two showed atypical bullous lesions.Responsible drugs were thio1-containing drugs in 11 patients,and non-thio1 drugs in 3 patients.However,the latter were all sulfur-containing drugs,and therefore possibly"masked"thiol drugs.By ELISA and/or immunoblot analyses,10 patients reacted only with desmoglein 1 （Dsg1）,three reacted with Dsg1 and Dsg3,and one reacted with neither.By immunoblotting,one patient reacted with the 190 kDa periplakin and another reacted with both periplakin and the 210 kDa envoplakin,two major paraneoplastic pemphigus autoantigens.While two patients had very protracted disease course,skin lesions in 12 cases disappeared quickly after cessation of causative drugs. Conclusions The present study indicated that the majority,possibly all,of the DIP cases studied showed pemphigus foliaceus-like phenotype with anti-Dsg1 autoantibodies,caused by thiol- or"masked"thiol-containing drugs.
The Second Eastern Asia Dermatology Congress（EADC2012）