The induction of pemphigus by phenol drugs

Goldberg, Ilan; Kashman, Yoel; Brenner, Sarah

doi:10.1046/j.1365-4362.1999.00836.x

Cited by 48 publications

(42 citation statements)

References 36 publications

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“…A non-immunological mechanism is at work even when drugs such as penicillin, cephalosporin and piroxicam do not contain a thiol group but may generate them through metabolic changes [9]. …”

Section: Discussionmentioning

confidence: 99%

Fosinopril as a Possible Pemphigus-Inducing Drug

Parodi¹,

Cozzani²,

Milesi³

et al. 2002

Dermatology

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Fosinopril has recently been added to the angiotensin-converting enzyme inhibitors inducing pemphigus. The observation of a patient in whom pemphigus vulgaris (PV) worsened after taking fosinopril prompted us to study an experimental way to assess its responsibility. Slices of normal human skin (NHS) were simultaneously incubated for 2, 6, 12 and 24 h at 4°C with progressively diluted fosinopril and captopril solutions and used as indirect immunofluorescence (IIF) substrates for 2 sera containing anti-desmoglein-3 (anti-Dsg3) antibodies at a dilution of 1/160. With captopril, IIF was negative, irrespective of dilution and time of incubation. Only at 1/40,000 dilution was IIF positive. With fosinopril, IIF was negative for the 2- and 6-hour-long incubations but turned positive after 12 h and so remained with all other solutions and incubation times. IIF negativity with captopril suggests that anti-Dsg3 antibodies contained in the PV sera were unable to find molecules in NHS to bind to. Captopril would therefore induce acantholysis by blocking the adhesion molecules. With fosinopril, instead, a partial block of the adhesion molecules was seen only with the very concentrated solution, unlikely to occur in vivo. Fosinopril, therefore, is probably unable to block the adhesion molecules in vivo. Our method might be used to verify the acantholytic properties of a drug.

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“…A non-immunological mechanism is at work even when drugs such as penicillin, cephalosporin and piroxicam do not contain a thiol group but may generate them through metabolic changes [9]. …”

Section: Discussionmentioning

confidence: 99%

Fosinopril as a Possible Pemphigus-Inducing Drug

Parodi¹,

Cozzani²,

Milesi³

et al. 2002

Dermatology

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“…We examined all purchases of medications that were previously associated with pemphigus 15,16,19,20 during the 6 months before the date that the pemphigus was first diagnosed. These medications included penicillins, cephalosporins, angiotensinconverting enzyme inhibitors, dipyrone, phenobarbiturate, topical anti-inflammatory drugs, and nonsteroidal antiinflammatory medications.…”

Section: Exposure Datamentioning

confidence: 99%

Pemphigus Variant Associated With Penicillin Use

Heymann¹,

Chodick²,

Kramer³

et al. 2007

Arch Dermatol

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“…In the literature, there are increasing numbers of reports of drug-induced pemphigus. [32][33][34][35][36][37][38] Topical and systemic medications have been suspected, and three groups of chemical structures can cause pemphigus: sulfhydryl radicals (thiol drugs or SH drugs), phenol drugs, and non-thiol non-phenol drugs (Table 4). Thiol and phenol drugs can cause acantholytic changes in the skin.…”

Section: Discussionmentioning

confidence: 99%