Wilson J P, Koren J F, Daniel R C, Chapman S W
Drug Intell Clin Pharm. 1986 Mar;20(3):219-23. doi: 10.1177/106002808602000309.
A 77-year-old patient is described who developed pemphigus vulgaris temporally with the administration of cefadroxil. The disease improved when the drug was discontinued but was exacerbated with the administration of ampicillin. This may be the first case of possible cefadroxil-induced and only the second case of ampicillin-induced pemphigus vulgaris reported. The pathophysiology, diagnosis, and treatment of pemphigus vulgaris is briefly described. Drug-induced pemphigus is reviewed. By far the most incriminated drug has been penicillamine. It is postulated that the sulfhydryl group of penicillamine alters the intercellular cement substance into an antigenic structure with subsequent antibody formation. The chemical similarity between penicillamine, the penicillins, and the cephalosporins is alluded to and the potential for cross-sensitivity between the penicillins and cephalosporins is emphasized. Although the pemphigus vulgaris could have occurred by chance, it seems probable that it was drug-induced.
本文描述了一名77岁的患者，其在服用头孢羟氨苄后出现寻常型天疱疮。停药后病情好转，但服用氨苄西林后病情加重。这可能是首例可能由头孢羟氨苄诱发的寻常型天疱疮病例，也是第二例有报道的由氨苄西林诱发的寻常型天疱疮病例。文中简要描述了寻常型天疱疮的病理生理学、诊断和治疗方法，并对药物性天疱疮进行了综述。迄今为止，最常被认为有嫌疑的药物是青霉胺。据推测，青霉胺的巯基将细胞间黏合物质改变为抗原结构，随后形成抗体。文中提到了青霉胺、青霉素和头孢菌素之间的化学相似性，并强调了青霉素和头孢菌素之间存在交叉敏感性的可能性。虽然寻常型天疱疮可能是偶然发生的，但似乎很可能是药物诱发的。
