Linear IgA bullous dermatosis (LABD) is a rare blistering autoimmune disease. Although most cases are idiopathic, numerous drugs have been identified as capable of eliciting LABD. This paper provides an overview of the pathogenesis, diagnosis and treatment of drug-induced LABD, together with a report of a representative case of vancomycin-induced LABD. In addition, the results of a comprehensive literature review are reported to provide an overview of putative culprit drugs and their frequency, in order to enable clinicians to diagnose patients with putative adverse drug reactions presenting with blistering. Linear IgA bullous dermatosis (LABD) is a rare subepidermal autoimmune blistering disease characterized by linear deposition of IgA along the basement membrane zone. Although most reported cases are idiopathic, there is a subset of patients with drug-induced LABD. Various drugs have been associated with the drug-induced form of the disease. This paper reviews the literature on drugs reported to elicit linear IgA dermatosis and its specific clinical presentation. In addition, a case report of a 77-year-old male patient with linear IgA dermatosis induced by vancomycin is described. The aim of this paper is to emphasize the need to include this differential diagnosis in cases of suspected adverse drug reactions, as well as to highlight the role of drugs in LABD.

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A 69-year-old woman with a history of acute generalized exanthematic pustulosis (AGEP) caused by metamizole is described. Furthermore, she had suffered from an untreated psoriasis since the age of 20. After an adequate therapy of both psoriasis and AGEP, yellow-brownish, static, coalescing, lucent nodules on the thighs and upper arms became apparent. Histology of skin biopsies revealed a prominent band of mature adipocytes in the dermis. We diagnosed a lipomatous metaplasia of the dermis and hypothesize that this metaplasia occurred as a consequence of the severe and chronic inflammation of the skin.

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