This paper is only available as a PDF. To read, Please Download here.
Abstract
Background: Medications are the most common triggers of linear immunoglobulin A bullous dermatosis
(LABD). LABD induced by ultraviolet (UV) radiation has rarely been described. This
article reports a case of LABD in a patient exposed simultaneously to an analgesic
and UV radiation.
Case summary: A 45-year-old woman developed LABD lesions on sun-exposed skin after 3 days of sunbathing
and consumption of a medication for headache containing propyphenazone, butalbital,
and caffeine. The lesions spread to unexposed skin and, by day 5, the patient had
vesicles and bullae on the palms and soles, face, trunk, and extremities. LABD was
diagnosed with direct and indirect immunofluorescence microscopy and Western blot
analysis. Treatment was successful with prednisone, started at a dosage of 1 mg/kg/d,
for 5 months. Lesions located on sunexposed areas, the absence of relapse for 5 years
despite continuing sun exposure against medical advice, and subsequent avoidance of
the suspected medication suggest that the bullous flare may have been due to the concomitant
action of 2 triggers. That the analgesic had a role in this cutaneous manifestation
is possible according to the Naranjo algorithm for adverse drug reactions.
Conclusions: A case of LABD possibly associated with sun exposure and an analgesic is described.
Treatment with prednisone successfully resolved the lesions in this patient.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Clinical TherapeuticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Linear IgA bullous dermatosis.Clin Dermatol. 2001; 19: 719-727
- Druginduced linear IgA bullous dermatosis.J Dermatol. 2005; 32: 759-764
- Linear IgA dermatosis: Association with malignancy.J Am Acad Dermatol. 1990; 22: 59-63
- Linear IgA bullous dermatosis associated with rheumatoid arthritis.J Am Acad Dermatol. 1992; 26: 110-113
- Linear IgA disease and ulcerative colitis.Br J Dermatol. 1997; 136: 779-782
- UV light-induced linear IgA dermatosis.J Am Acad Dermatol. 2004; 50: 109-115
- Dermatose a IgA linèaire photo-aggravèe.Ann Dermatol Venereol. 1987; 114: 1358-1359
- Localized linear IgA dermatosis induced by UV light-treatment for herpes zoster.Int J Dermatol. 2007; 46: 500-502
- Comparative expression of bullous pemphigoid antigens in normal human epidermis and cultured keratinocytes.Clin Immunol Immunopathol. 1989; 51: 406-413
- Cutaneous reactions to nonsteroidal anti-inflammatory drugs. A review.J Am Acad Dermatol. 1985; 12: 866-876
- IgEmediated immediate-type hypersensitivity to the pyrazolone drug propyphenazone.J Allergy Clin Immunol. 2003; 111: 882-888
- Pemphigus and bullous pemphigoid due to drugs.Int J Dermatol. 1991; 30: 307-312
- Cutaneous reactions to nonsteroidal anti-inflammatory drugs. Author's reply.J Am Acad Dermatol. 1995; 33: 320-321
- A method for estimating the probability of adverse drug reactions.Clin Pharmacol Ther. 1981; 30: 239-245
- Druginduced photoallergic and phototoxic reactions.Expert Opin Drug Saf. 2007; 6: 431-443
Article info
Publication history
Accepted:
August 6,
2009
Identification
Copyright
© 2009 Excerpta Medica Inc. All rights reserved. Published by Elsevier Inc.
