Department of Allergy and Clinical Immunology, Iran University of Medical Sciences, Tehran, Iran.
Department of Dermatology, Razi Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Iran J Allergy Asthma Immunol. 2020 Oct 18;19(5):550-554. doi: 10.18502/ijaai.v19i5.4473.
Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering disease that may be triggered by some diseases and medications. For the latter one, non-steroidal anti-inflammatory drugs (NSAIDs) have been identified as one of the potential causative agents to develop LABD. Here, a rare case of drug-induced LABD is introduced. A 13-month-old Iranian boy presented with a history of generalized blisters, displaying the classic "string of pearls" sign who was eventually diagnosed as a case of LABD. In his admission, he was diagnosed whit Mucocutaneous lymph node syndrome and treated with aspirin. Some features like appearing the characteristic lesions one week following the administration of aspirin, rapid clearance of lesions after the withdrawal of the drug, and reappearance of new lesions after readministration of aspirin were highly suggestive of aspirin-induced LABD. To establish the diagnosis, we used the "Naranjo probability score" which determined the probable causative role of aspirin. The diagnosis was confirmed by showing the positive IgA deposition in the basement membrane zone in a direct immunofluorescence study of the skin biopsy. The child was treated with dapsone with dramatical response to the drug.
线性 IgA 大疱性皮病(LABD)是一种罕见的自身免疫性疱病,可能由某些疾病和药物引发。对于后者,非甾体抗炎药(NSAIDs)已被确定为引发 LABD 的潜在原因之一。本文介绍了一例罕见的药物诱导的 LABD。一名 13 个月大的伊朗男童,全身出现水疱,呈现典型的“串珠”征,最终被诊断为 LABD 病例。入院时,他被诊断为黏膜皮肤淋巴结综合征,并接受了阿司匹林治疗。一些特征,如在服用阿司匹林后一周出现特征性皮损、停药后皮损迅速消退、再次服用阿司匹林后出现新皮损,高度提示为阿司匹林诱导的 LABD。为了确立诊断,我们使用了“Naranjo 概率评分”来确定阿司匹林的可能致病作用。皮肤活检的直接免疫荧光研究显示 IgA 在基底膜带沉积,从而确诊。患儿接受了氨苯砜治疗,对药物反应良好。