Dermatology Book

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Drug-Induced PemphigusAka: Drug-Triggered Pemphigus

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  1. See Also
    1. Bullous Disease
    2. Pemphigus
  2. Mechanism of Drug-Induced Pemphigus
    1. Sulfhydryl groups lyse disulfide bonds
    2. Results in Blister formation
  3. Causes of Drug-Induced Pemphigus
    1. D-Penicillamine (5% Incidence with Penicillamine)
    2. Captopril
  4. Signs of Drug-Induced Pemphigus
    1. Pemphigus follows medication use of >2 month duration
    2. Similar to Superficial Pemphigus (Pemphigus Foliaceus)
      1. Most cases are mild
  5. Differential Diagnosis of Drug-Induced Pemphigus
    1. Erythema Multiforme
    2. Drug-Triggered Pemphigus (unmasks Pemphigus Vulgaris)
      1. Rifampin
      2. Penicillin
      3. Cephalexin
      4. Progesterone
      5. Gold
      6. Piroxicam
      7. Phenobarbital
  6. Course
    1. Drug-Induced Pemphigus
      1. Remits with stopping medication in 40-50% of cases
      2. May follow severe course in some cases
    2. Drug-Triggered Pemphigus
      1. Does not remit
      2. Follows course of Pemphigus Vulgaris
  7. References
    1. Habif (1996) Clinical Dermatology, Mosby, p. 512
    2. Cotell (2000) Am J Emerg Med 18(3):288
    3. Rye (1997) Am Fam Physician 55(8):2709

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