[Verapamil-induced linear IgA disease mimicking toxic epidermal necrolysis]

Ann Dermatol Venereol. 2011;138(4):302-6. doi: 10.1016/j.annder.2010.10.028. Epub 2011 Jan 22.
[Article in French]

Abstract

Background: Linear IgA bullous dermatosis is a rare auto-immune bullous dermatitis characterized by linear IgA deposits in the basal membrane zone. Clinical diagnosis may be difficult due to the various clinical presentations mimicking bullous pemphigoid, pemphigus, erythema multiforme or toxic epidermal necrolysis. Linear IgA may be idiopathic or due to drugs, particularly vancomycin.

Patients and methods: We describe a 91-year-old woman treated with verapamil for coronary disease who developed an eruption presenting as a toxic epidermal necrolysis, although the diagnosis was amended after direct immunofluorescence revealed IgA deposits in the basal membrane zone.

Discussion: Ours appears to be the first reported case of verapamil-induced linear IgA bullous dermatosis.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Aged, 80 and over
  • Angina Pectoris / drug therapy*
  • Autoimmune Diseases / chemically induced*
  • Autoimmune Diseases / diagnosis
  • Autoimmune Diseases / pathology
  • Basement Membrane / pathology
  • Biopsy
  • Calcium Channel Blockers / therapeutic use
  • Calcium Channel Blockers / toxicity*
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoglobulin A / metabolism*
  • Microscopy, Fluorescence
  • Skin / drug effects
  • Skin / pathology
  • Skin Diseases, Vesiculobullous / chemically induced*
  • Skin Diseases, Vesiculobullous / diagnosis
  • Skin Diseases, Vesiculobullous / pathology
  • Stevens-Johnson Syndrome / diagnosis*
  • Stevens-Johnson Syndrome / pathology
  • Verapamil / therapeutic use
  • Verapamil / toxicity*

Substances

  • Calcium Channel Blockers
  • Immunoglobulin A
  • Verapamil