Drug-induced pemphigus

Pisani, M; Ruocco, Vincenzo

doi:10.1016/0738-081x(86)90015-5

Cited by 108 publications

(25 citation statements)

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“…Pemphigus or pemphigoid autoantibodies have been reported to occur specifically in pemphigus or pemphigoid patients [2, 3, 4, 19]or in bullous diseases including paraneoplastic pemphigus [20, 21, 22]and drug-induced pemphigus [23, 24]. These results were obtained by the immunofluorescent technique, immunoblotting methods and the ELISA against Dsg1 and Dsg3 using patient sera.…”

Section: Discussionmentioning

confidence: 53%

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Antidesmoglein Autoantibodies in Silicosis Patients with No Bullous Diseases

Ueki¹,

Kohda²,

Nobutoh³

et al. 2001

Dermatology

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Background: Pemphigus is an autoimmune bullous disease characterized by the presence of antidesmoglein autoantibodies. However, the mechanism of its autoantibody production remains unknown. In previous reports, we have described rare cases of pemphigus and pemphigoid associated with silicosis. It is well known that during long-term silicosis, some autoimmune diseases, such as systemic sclerosis, systemic lupus erythematosus or rheumatoid arthritis, can occur. Objective: The aim of this study was to explore the presence of pemphigus or pemphigoid autoantibodies in silicosis patients without clinical bullous diseases or collagen diseases. Method: The presence of pemphigus antibodies was examined in 54 silicosis patients with no associated bullous diseases, using immunofluorescence, the enzyme-linked immunosorbent assay (ELISA) for desmoglein 1 and 3, and immunoblotting methods. In the antibody-positive cases, HLA genotyping of peripheral lymphocytes was performed with PCR-RFLP. Results: Seven out of the 54 patients were found to be positive for pemphigus antibodies and 1 for bullous pemphigoid by immunofluorescence. In addition, by ELISA, 6 patients were found to be positive against the desmoglein 1 antigen, 2 against the desmoglein 3 antigen and 2 against both desmoglein 1 and desmoglein 3. Conclusion: The results of the present study strongly suggest the occurrence of pemphigus and pemphigoid autoantibodies in patients with silicosis. It remains unclear whether such patients will develop an autoimmune bullous disease in the future. Accordingly, long-term follow-up of antibody-positive patients is required.

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Section: Discussionmentioning

confidence: 53%

“…Certain drugs [23, 24], such as angiotensin-converting enzyme inhibitors or D -penicillamine, or internal malignant tumors [20, 21, 22]in paraneoplastic pemphigus are examples of environmental factors reported previously.…”

Section: Discussionmentioning

confidence: 99%

Antidesmoglein Autoantibodies in Silicosis Patients with No Bullous Diseases

Ueki¹,

Kohda²,

Nobutoh³

et al. 2001

Dermatology

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“…Their involvement in the pathomechanisms leading to the outbreak of pemphigus has often been suspected on the basis of circumstantial evidence, but sometimes it can be demonstrated with certainty (e.g. penicillamine- induced pemphigus, paraneoplastic pemphigus) [4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. As for certain drugs, their potential of provoking acantholytic changes has been confirmed by several experimental investigations [13].…”

Section: Introductionmentioning

confidence: 91%

“…In the last two decades there has been a growing body of evidence that drugs may exacerbate, trigger or even cause pemphigus in predisposed subjects [4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14]. In fact, drugs remain by far the most implicated exogenous factor in pemphigus induction.…”

Section: Drug Intakementioning

confidence: 99%

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Precautions and Suggestions for Pemphigus Patients

2001

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The onset and course of pemphigus are often the result of an interaction between predisposing genetic factors and environmental triggering agents. The latter are heterogeneous, numerous and increasing, ranging from drug intake (the commonest cause of pemphigus induction) to the exposure to physical agents (heat, UV and ionizing rays, surgical and cosmetic procedures), viral infections (especially by herpesvirus), contact dermatitis, certain diet ingredients and even emotional stress. Alerting physicians and pemphigus patients to the effects that unsuspected precipitating factors may have on the progression of the disease is an important task. In fact, avoiding or limiting deleterious habits (e.g. overindulging in unnecessary drugs) and suggesting alternative ways (e.g. substituting potentially pemphigus-inducing drugs with others considered harmless in this respect) may be a useful precaution in the management of pemphigus patients, since it can improve the efficacy of conventional treatments, reduce the risks of relapses and sometimes result in a cure.

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