Sandakly Nicolas, El Koubayati Georgio, Nassereddine Hussein, Haddad Fady
Internal Medicine, Lebanese University Faculty of Medicine, Beirut, LBN.
Clinical Immunology, Lebanese University Faculty of Medicine, Beirut, LBN.
Cureus. 2024 Nov 22;16(11):e74246. doi: 10.7759/cureus.74246. eCollection 2024 Nov.
Bullous pemphigoid (BP) is the most prevalent autoimmune subepidermal blistering disease of the skin and mucous membranes. This disease typically affects the elderly and manifests with pruritus and localized or, most commonly, generalized bullous lesions. Numerous studies have established the association between BP and oral antidiabetic agents, particularly dipeptidyl peptidase 4 (DPP4) inhibitors, diuretics, and certain antibiotics, notably levofloxacin and cephalexin. In this report, we present a case of an 85-year-old female who presented with diffuse vesicles and bullae on her trunk and extremities five days after completing a four-week course of cefixime for pyelonephritis. Clinical examination and histopathological analysis confirmed the diagnosis of BP. The patient responded well to topical and systemic corticosteroids. This article presents the first documented case of BP induced by cefixime and underscores the importance of considering medication-induced BP in elderly patients presenting with blistering eruptions.
大疱性类天疱疮（BP）是皮肤和黏膜最常见的自身免疫性表皮下大疱性疾病。这种疾病通常影响老年人，表现为瘙痒以及局限性或最常见的全身性大疱性皮损。大量研究已证实BP与口服抗糖尿病药物之间存在关联，尤其是二肽基肽酶4（DPP4）抑制剂、利尿剂以及某些抗生素，特别是左氧氟沙星和头孢氨苄。在本报告中，我们呈现了一例85岁女性病例，该患者在完成为期四周的头孢克肟治疗肾盂肾炎疗程五天后，躯干和四肢出现弥漫性水疱和大疱。临床检查和组织病理学分析确诊为BP。患者对局部和全身使用皮质类固醇治疗反应良好。本文介绍了首例有记录的由头孢克肟诱发的BP病例，并强调了在出现水疱性皮疹的老年患者中考虑药物性BP的重要性。
