Ruocco V, Satriano R A, Guerrera V
Department of Dermatology, First School of Medicine, University of Naples, Italy.
Int J Dermatol. 1992 Jan;31(1):33-6. doi: 10.1111/j.1365-4362.1992.tb03517.x.
Pemphigus lesions appeared in a 58-year-old man who was taking captopril for his hypertension. Drug withdrawal resulted in complete remission of the eruption. The subsequent use of enalapril as an antihypertensive agent caused a recurrence of pemphigus lesions along with onset of itching and dermographism. Intercellular antibodies were not found. Discontinuance of enalapril therapy had no effect on the clinical course. Steroid treatment was needed to resolve the eruption. Recently repeated immunofluorescent studies disclosed intercellular IgG antibodies in the serum at a low titer. Pemphigus induction could be initially related to the thiol acantholytic property of captopril. Subsequent production of intercellular antibodies and drug-activation of the kinin system could be responsible for relapsing.
一名58岁的男性在服用卡托普利治疗高血压时出现了天疱疮皮损。停药后皮疹完全消退。随后使用依那普利作为抗高血压药物导致天疱疮皮损复发，并伴有瘙痒和皮肤划痕症的出现。未发现细胞间抗体。停用依那普利治疗对临床病程无影响。需要使用类固醇治疗来消退皮疹。最近重复进行的免疫荧光研究显示血清中存在低滴度的细胞间IgG抗体。天疱疮的诱发最初可能与卡托普利的巯基棘层松解特性有关。随后细胞间抗体的产生和激肽系统的药物激活可能是复发的原因。
