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Pemphigus foliaceus induced by an angiotensin II receptor blocker
Author(s) -
Bae Y. I.,
Yun S. J.,
Lee S. C.,
Park G. T.,
Lee J. B.
Publication year - 2008
Publication title -
clinical and experimental dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.587
H-Index - 78
eISSN - 1365-2230
pISSN - 0307-6938
DOI - 10.1111/j.1365-2230.2008.02857.x
Subject(s) - pemphigus foliaceus , medicine , bulla (seal) , dermatology , histopathology , angiotensin receptor , pemphigus , pemphigus vulgaris , telmisartan , losartan , autoantibody , pathology , angiotensin ii , immunology , receptor , antibody , lung , blood pressure
Summary A 76‐year‐old Korean woman presented with pruritic erythematous vesicles and crusted plaques over her entire body. She had been taking an angiotensin II receptor blocker (ARB) (candesartan) for 2 months before developing the skin lesions. The patients was diagnosed with pemphigus foliaceus based on the clinical and immunopathological criteria, including intra‐epidermal bulla on skin histopathology, intercellular deposit of C 3 and IgG on direct immunofluorescence, and autoantibodies to the 160‐kDa antigen on both immunoblot and ELISA. The medication was changed to another antihypertensive agent and the patient was treated with prednisolone for 2 months. The vesiculobullous skin lesions gradually disappeared. However, the skin lesions reappeared 2 months after starting a different ARB (telmisartan). This case illustrates the importance of taking a complete drug history in patients who present with bullous diseases. Furthermore, ARBs should be added to the list of nonthiol drugs that can possibly induce pemphigus.