Bullous pemphigoid-like lesions induced by phenacetin. Report of a case and an immunopathologic study

Pemphigoid nodularis associated with nifedipine

“… 5 Drug‐induced BP can be acute and self‐limiting, with resolution following withdrawal of the offending drug, or persistent, in which the drug appears to have initiated idiopathic BP, and this was observed in our patient. 6 IMF studies may reveal tissue‐bound and circulating anti‐BMZ antibodies, 4 , 7 and the antigen in drug‐induced BP has been identified as identical to that in idiopathic BP, 6 as in our case.…”

A Systematic Review of Drug-Induced Pemphigoid

“…Rechallenge has been performed with aspirin, diclofenac, phenacetin and sulfasalazine with recurrence further supporting an association ( 25 , 31 ).…”

“…Histological features of DABP encompass a few different findings seen often than idiopathic BP ( 33 ). No specific antigens for DABP have been identified, suggesting that the antigens are, at least in part, the same of the ones detected in the idiopathic BP (IBP) ( 25 , 34 ). Immunofluorescence reveals a similar profile to IBP.…”

“…Drugs may alter these antigenic properties by binding to molecules in the lamina lucida of the BMZ, thereby acting as neoantigens, and inducing the formation anti-BMZ antibodies ( 22 , 23 ). Alternatively, they may structurally modify molecules and uncover previously hidden epitopes, hence stimulating the immune response ( 24 , 25 ). Indeed, Patsatsi et al ( 26 ) revealed an elevated titre of anti-BP180NC16A auto-antibodies in a group of patients receiving systemic medications prior to the development of the disease, when compared to the those receiving no medications, supporting the theory of drug-associated epitope spreading.…”

Bullous Pemphigoid Induced by Cefixime: A Rare Side Effect

“…Sulfur-containing drugs, exemplified by penicillamine and captopril, can directly cause acantholytic splitting leading to the disruption of the dermoepidermal junction without any immune-mediated process by interacting between the sulfhydryl groups in desmosomes and BMZ [ 12 ]. Another possible theory considers that certain drugs may alter the antigenicity of structures within the lamina lucida, acting as a hapten that binds to and modifies protein molecules in the basement membrane, thereby exposing hidden antigenic sites [ 13 ]. A retrospective study conducted by Patsatsi et al [ 14 ] reported statistically significant increased titers of circulating anti-BP180 auto-antibodies in BP patients receiving various systemic medications before disease onset when compared to BP patients who never received any medications, supporting the hypothesis of drug-induced antigenic alterations acting as hapten.…”