Abstract
We describe a patient who developed an exclusively perianal-intergluteal vesicular eruption after receiving a course of ampicillin/sulbactam. Direct immunofluorescence microscopy of perilesional skin demonstrated linear deposits of IgA along the dermal-epidermal junction. Circulating IgA autoantibodies against the 120-kd soluble ectodomain of bullous pemphigoid antigen 180 (LAD-1 autoantigen) were detected by immunoblotting. Discontinuation of the antibiotics resulted in a rapid resolution of the skin lesions. This is a most unusual case of localized drug-induced linear IgA disease.
Publication types
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Case Reports
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Ampicillin / adverse effects*
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Anti-Bacterial Agents / adverse effects*
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Autoantibodies / blood
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Autoantigens / immunology*
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Autoimmune Diseases / chemically induced*
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Biopsy
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Carrier Proteins
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Collagen Type XVII
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Cytoskeletal Proteins
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Drug Eruptions / etiology*
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Drug Eruptions / immunology
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Dystonin
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Humans
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Immunoglobulin A / blood*
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Male
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Nerve Tissue Proteins
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Non-Fibrillar Collagens
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Skin / pathology
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Skin Diseases, Vesiculobullous / chemically induced*
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Skin Diseases, Vesiculobullous / immunology
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Sulbactam / adverse effects*
Substances
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Anti-Bacterial Agents
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Autoantibodies
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Autoantigens
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Carrier Proteins
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Cytoskeletal Proteins
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DST protein, human
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Dystonin
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Immunoglobulin A
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Nerve Tissue Proteins
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Non-Fibrillar Collagens
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sultamicillin
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Ampicillin
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Sulbactam