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Corrà A, Bonciolini V, Quintarelli L, Verdelli A, Caproni M. Linear IGA bullous dermatosis potentially triggered by vaccination. Int J Immunopathol Pharmacol 2022; 36:20587384211021218. [PMID: 35001680 PMCID: PMC8753231 DOI: 10.1177/20587384211021218] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 05/06/2021] [Indexed: 11/16/2022] Open
Abstract
Linear IgA bullous dermatosis (LABD) is a mucocutaneous autoimmune blistering disease affecting both adults and children. It is caused by IgA antibodies targeting multiple antigens along the basement membrane zone, leading to disruption of dermoepidermal junction and development of bullous lesions which often presents in characteristic arrangement. Although most LABD cases have been reported to be idiopathic, different triggers have been described, including several drugs and infection. However, the occurrence of vaccine-induced cases of LABD is not widely known and accepted due to the few reports available. We present two cases of LABD occurred following different triggers, rising the suspicion for a possible pathogenetic role of vaccines.
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Affiliation(s)
- Alberto Corrà
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Veronica Bonciolini
- Dermatology Unit, Versilia Hospital, USL Toscana Nord-Ovest, Lido di Camaiore, Lucca, Italy
| | - Lavinia Quintarelli
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
| | - Alice Verdelli
- Department of Experimental and Clinical Biomedical Sciences ‘Mario Serio’, University of Florence, Florence, Italy
| | - Marzia Caproni
- Section of Dermatology, Department of Health Sciences, University of Florence, Florence, Italy
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2
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Tabka M, Gammoudi R, Fathallah N, Ghariani N, Sriha B, Ben Salem C, Denguezli M. Linear IgA bullous dermatosis: A rare manifestation of amoxicillin-clavulanic acid treatment. Dermatol Ther 2020; 33:e14187. [PMID: 32789977 DOI: 10.1111/dth.14187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/06/2020] [Accepted: 08/10/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Meriam Tabka
- Department of Dermatology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Rima Gammoudi
- Department of Dermatology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Neila Fathallah
- Department of Pharmacovigilance, Reference Centre for Cutaneous Adverse Reactions, University of Sousse, Sousse, Tunisia
| | - Nejet Ghariani
- Department of Dermatology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Badreddine Sriha
- Department of Pathology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
| | - Chaker Ben Salem
- Department of Pharmacovigilance, Reference Centre for Cutaneous Adverse Reactions, University of Sousse, Sousse, Tunisia
| | - Mohamed Denguezli
- Department of Dermatology, University of Sousse, Farhat Hached Hospital, Sousse, Tunisia
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Giraud L, Welfringer-Morin A, Boccara O, Frassati-Biaggi A, Leclerc-Mercier S, Grootenboer-Mignot S, Bodemer C, Hadj-Rabia S. Neonatal and self-healing linear immunoglobulin A dermatosis. J Eur Acad Dermatol Venereol 2019; 34:e86-e87. [PMID: 31574167 DOI: 10.1111/jdv.15989] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- L Giraud
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris Centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - A Welfringer-Morin
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris Centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - O Boccara
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris Centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - A Frassati-Biaggi
- Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - S Leclerc-Mercier
- Department of Pathology, Necker-Enfants Malades Hospital, APHP, Paris, France
| | - S Grootenboer-Mignot
- Department of Immunology, APHP, Bichat Hospital, Inserm UMR 1152, Université Paris Diderot Paris 7, Paris, France
| | - C Bodemer
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris Centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
| | - S Hadj-Rabia
- Dermatology and Reference Center for Genodermatoses and Rare Skin Diseases (MAGEC), Université de Paris Centre, Institut Imagine, Hôpital Universitaire Necker-Enfants Malades, APHP, Paris, France
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Alraddadi BS, Magliah T, Al Otaibi Y. Case Report: Linear IgA Bullous Dermatosis Triggered by Amoxicillin-clavulanic acid. ACTA ACUST UNITED AC 2018. [DOI: 10.32648/2639-3298/1/1/002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Linear IgA bullous dermatosis (LABD) is rare autoimmune disease that can be caused with or without drugs. We present a 32 year old male with LABD secondary to Amoxicillin-clavulanic acid with complete recovery after the antibiotic was discontinued.
Keywords: Linear IgA Bullous disease, Vancomycin, Amoxicillin-clavulanic acid
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Affiliation(s)
| | - Tahani Magliah
- Senior dermatology resident, King abdulaziz medical city, jeddah, Saudi Arabia
| | - Yasser Al Otaibi
- Dermatologist, King fahad armed force hospital, Jeddah, Saudi Arabia
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Konvinse KC, Phillips EJ, White KD, Trubiano JA. Old dog begging for new tricks: current practices and future directions in the diagnosis of delayed antimicrobial hypersensitivity. Curr Opin Infect Dis 2016; 29:561-576. [PMID: 27753687 PMCID: PMC5113146 DOI: 10.1097/qco.0000000000000323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE OF REVIEW Antimicrobials are a leading cause of severe T cell-mediated adverse drug reactions (ADRs). The purpose of this review is to address the current understanding of antimicrobial cross-reactivity and the ready availability of and evidence for in-vitro, in-vivo, and ex-vivo diagnostics for T cell-mediated ADRs. RECENT FINDINGS Recent literature has evaluated the efficacy of traditional antibiotic allergy management, including patch testing, skin prick testing, intradermal testing, and oral challenge. Although patch and intradermal testing are specific for the diagnosis of immune-mediated ADRs, they suffer from drug-specific limitations in sensitivity. The use of ex-vivo diagnostics, especially enzyme-linked immunospot, has been highlighted as a promising new approach to assigning causality. Knowledge of true rates of antimicrobial cross-reactivity aids empirical antibiotic choice in the setting of previous immune-mediated ADRs. SUMMARY In an era of increasing antimicrobial resistance and use of broad-spectrum antimicrobial therapy, ensuring patients are assigned the correct 'allergy label' is essential. Re-exposure to implicated antimicrobials, especially in the setting of severe adverse cutaneous reaction, is associated with significant morbidity and mortality. The process through which an antibiotic label gets assigned, acted on and maintained is still imprecise. Predicting T cell-mediated ADRs via personalized approaches, including human leukocyte antigen-typing, may pave future pathways to safer antimicrobial prescribing guidelines.
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Affiliation(s)
- Katherine C Konvinse
- aDepartment of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA bInstitute for Immunology and Infectious Diseases, Murdoch University, Western Australia, Australia cDepartment of Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA dDepartment of Medicine, Division of Infectious Diseases, Vanderbilt University Medical Center, Nashville, Tennessee, USA eDepartment of Infectious Diseases, Austin Hospital, Victoria, Australia fDepartment of Infectious Diseases, Alfred Hospital, Victoria, Australia gDepartment of Infectious Diseases, Peter MacCallum Cancer Centre, Victoria, Australia hDepartment of Medicine, University of Melbourne, Victoria, Australia
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Fortuna G, Salas-Alanis JC, Guidetti E, Marinkovich MP. A critical reappraisal of the current data on drug-induced linear immunoglobulin A bullous dermatosis: A real and separate nosological entity? J Am Acad Dermatol 2012; 66:988-94. [DOI: 10.1016/j.jaad.2011.09.018] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 09/08/2011] [Accepted: 09/20/2011] [Indexed: 01/22/2023]
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Abstract
The presence of one autoimmune disorder helps lead to the discovery of other autoimmune conditions. It is thought that diseases in which autoimmunity is a feature tend to be associated together more often than one can ascribe to chance. A variety of diseases have been implicated in the onset of intraepidermal and subepidermal autoimmune diseases. The presence of one autoimmune disease should alert the physician to watch for a second immunologic disorder. A list of autoimmune bullous diseases associations includes autoimmune bullous diseases, pemphigus, pemphigoid, epidermolysis bullosa acquisita, dermatitis herpetiformis (Duhring), linear immunoglobulin A disease, and multiple autoimmune syndrome.
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Affiliation(s)
- Suzana Ljubojevic
- University Department of Dermatology and Venereology, University Hospital Center Zagreb, School of Medicine,University of Zagreb, Croatia.
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Panasiti V, Rossi M, Devirgiliis V, Curzio M, Bottoni U, Calvieri S. Amoxicillin-clavulanic acid-induced linear immunoglobulin A bullous dermatosis: case report and review of the literature. Int J Dermatol 2009; 48:1006-10. [DOI: 10.1111/j.1365-4632.2009.04104.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Atzori L, Pinna AL, Pilloni L, Ferreli C, Pau M, Aste N. Bullous skin eruption in an HIV patient during antiretroviral drugs therapy. Dermatol Ther 2008; 21 Suppl 2:S30-4. [PMID: 18837731 DOI: 10.1111/j.1529-8019.2008.00230.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Dermo-epidermal blistering is an uncommon presentation of adverse drug reactions. Several drugs are associated to such eruptions, but review of current knowledge does not list antiretroviral drugs. A 37-year-old Caucasian HIV-positive woman presented with a 6-week history of diffuse annular blistering affecting the trunk and limbs. Lesions appeared both on erythematous and normal-appearing skin. The patient was in treatment with antiretroviral (lamivudine + didanosine + nelfinavir) for 2 years. A history of previous adverse reactions to betalactams, nonsteroidal anti-inflammatory drugs, and a nevirapine-induced hepatitis was also referred. Histopathology showed a dermo-epidermal blister; direct immunofluorescence was positive for IgG, C3c at the basement membrane zone; enzyme-linked immunosorbent assay was positive for BP180 antigen. Oral prednisone 1 mg/kg daily for 20 days led to poor improvement. Discontinuation of the antiretrovirals was followed by a rapid healing. Blisters reappeared at first re-introduction essay 1 month later. Awareness of iatrogenic dermo-epidermal blistering is necessary to suspect the diagnosis and avoid long-term immunosuppressant treatment. Complete spontaneous recovery after withdrawal of the responsible drug and relapse at rechallenge are the main criteria for the diagnosis. Factors related to the state of the HIV infection, and/or immunodeficiency may have contributed in precipitating the reaction in the present authors' case.
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Affiliation(s)
- Laura Atzori
- Dermatology Department, University of Cagliari, Italy.
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2008. [DOI: 10.1002/pds.1485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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