Angiotensin-converting enzyme inhibitor-induced pemphigus: three case reports and literature review.

OBJECTIVE

To identify patients examined in the Mayo Clinic Department of Dermatology whose pemphigus was attributable to an angiotensin-converting enzyme inhibitor and to compare these cases with previously reported cases of drug-induced pemphigus.

RESULTS

A retrospective review of medical records revealed two cases of captopril-induced pemphigus and one of enalapril-induced pemphigus. Our patients had substantially increased circulating IgG autoantibodies to intercellular substance, as detected on monkey esophagus substrate.

CONCLUSION

Our findings contrast those of other reports of drug-induced pemphigus in which circulating autoantibodies are implied to be low or absent.