Buffon Stefano, Parietti Michele, Carugno Andrea, Test Elisa Robustelli, Marzano Angelo Valerio, Sena Paolo, Vezzoli Pamela
Dermatology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan.
Department of Pathophysiology and Transplantation, University of Milan.
Dermatol Reports. 2023 Aug 29;16(3):9831. doi: 10.4081/dr.2023.9831. eCollection 2024 Sep 2.
Linear immunoglobulin (Ig) A disease (LAD) is a rare autoimmune blistering dermatosis caused by linear deposition of IgA1 along the dermoepidermal junction of skin and mucosae. It can affect both children and adults. Although idiopathic in most cases, it can also be associated with infections, malignancies, or drug administration. Among medications, antibiotics are most commonly responsible, particularly vancomycin. We report the case of a 51-year-old female patient who developed mucocutaneous LAD after oral metronidazole administration, which was confirmed by histopathological examination and direct immunofluorescence of one of the bullous lesions. Lesions rapidly cleared after metronidazole discontinuation and a short course of oral methylprednisolone and dapsone. To our knowledge, this is the third reported case of metronidazole-induced LAD and the first in which metronidazole was not administered in combination with other antibiotics such as ceftriaxone.
线状免疫球蛋白A病（LAD）是一种罕见的自身免疫性水疱性皮肤病，由IgA1沿皮肤和黏膜的真皮表皮交界处呈线状沉积所致。它可累及儿童和成人。虽然大多数情况下为特发性，但也可与感染、恶性肿瘤或药物使用有关。在药物中，抗生素最为常见，尤其是万古霉素。我们报告一例51岁女性患者，口服甲硝唑后发生黏膜皮肤LAD，经组织病理学检查和其中一个水疱性皮损的直接免疫荧光检查确诊。停用甲硝唑并短期口服甲泼尼龙和氨苯砜后，皮损迅速消退。据我们所知，这是第三例报告的甲硝唑诱发的LAD病例，也是首例未与头孢曲松等其他抗生素联合使用甲硝唑的病例。
