eMedicine Specialties > Dermatology > Bullous Diseases

Pemphigus, Drug-Induced: Follow-up

Author: Diane M Scott, MD, Dermatologist and Dermatopathologist, Palm Beach Dermatology
Coauthor(s): Daniel Davis, MD, Associate Professor, Departments of Dermatology, Otolaryngology, and Pathology, University of Arkansas for Medical Sciences; Kimberly I Soderberg, MD, Staff Physician, Department of Dermatology, University of Arkansas for Medical Sciences
Contributor Information and Disclosures

Updated: Jun 11, 2007

Follow-up

Complications

  • Secondary infections may occur because of the disruption of the skin barrier. Extensive erosions may promote entrance of bacteria, resulting in cutaneous infections, bacteremia, or sepsis.

Prognosis

  • Patients with thiol-induced pemphigus and patients lacking cell surface autoantibodies have a more favorable prognosis. Up to 50% of thiol-induced pemphigus cases remit upon withdrawal of the drug.
  • Patients with pemphigus induced by nonthiol drugs are more likely to have cell surface antibodies and to have a chronic course similar to idiopathic pemphigus vulgaris.

Patient Education

  • Educate patients about their disease and their medications, including adverse effects from therapy.
  • The International Pemphigus and Pemphigoid Foundation, a nonprofit support group for patients with pemphigus and their families, offers an active web site and a quarterly newsletter, as well as local chapters in many parts of the country.

Miscellaneous

Medicolegal Pitfalls

  • Failure of dermatologists and other providers to be alert to the role of drugs in causing pemphigus. Offending agents must be stopped and the patient treated appropriately.
 


More on Pemphigus, Drug-Induced

Overview: Pemphigus, Drug-Induced
Differential Diagnoses & Workup: Pemphigus, Drug-Induced
Treatment & Medication: Pemphigus, Drug-Induced
Follow-up: Pemphigus, Drug-Induced
References
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References

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  2. Anhalt GJ. Drug-induced pemphigus. Semin Dermatol. Sep 1989;8(3):166-72. [Medline].

  3. Brenner S, Bialy-Golan A, Anhalt GJ. Recognition of pemphigus antigens in drug-induced pemphigus vulgaris and pemphigus foliaceus. J Am Acad Dermatol. Jun 1997;36(6 Pt 1):919-23. [Medline].

  4. Brenner S, Bialy-Golan A, Ruocco V. Drug-induced pemphigus. Clin Dermatol. May-Jun 1998;16(3):393-7. [Medline].

  5. Brenner S, Wolf R, Ruocco V. Drug-induced pemphigus. I. A survey. Clin Dermatol. Oct-Dec 1993;11(4):501-5. [Medline].

  6. Goldberg I, Sasson A, Gat A. Pemphigus vulgaris triggered by glibenclamide and cilazapril. Acta Dermatovererol Croat. Oct 1975;13(3):153-3. [Medline].

  7. Grando SA. Cholinergic control of epidermal cohesion. Exp Dermatol. Apr 2006;15(4):265-82. [Medline].

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  9. Landau M, Brenner S. Histopathologic findings in drug-induced pemphigus. Am J Dermatopathol. Aug 1997;19(4):411-4. [Medline].

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Further Reading

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Keywords

drug-induced pemphigus, antibiotic-induced pemphigus, medication-induced pemphigus, thiol-induced pemphigus, pyrazolone-induced pemphigus

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Contributor Information and Disclosures

Author

Diane M Scott, MD, Dermatologist and Dermatopathologist, Palm Beach Dermatology
Diane M Scott, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

Coauthor(s)

Daniel Davis, MD, Associate Professor, Departments of Dermatology, Otolaryngology, and Pathology, University of Arkansas for Medical Sciences
Disclosure: Nothing to disclose.

Kimberly I Soderberg, MD, Staff Physician, Department of Dermatology, University of Arkansas for Medical Sciences
Kimberly I Soderberg, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Arkansas Medical Society, and Women's Dermatological Society
Disclosure: Nothing to disclose.

Medical Editor

David Woodley, MD, Co-Chair, Professor, Department of Medicine, Division of Dermatology, University of Southern California
David Woodley, MD, Co-Chair is a member of the following medical societies: American Academy of Dermatology, American Association for the Advancement of Science, American College of Emergency Physicians, American College of Physicians, American Federation for Medical Research, American Society for Clinical Investigation, New York Academy of Medicine, Society for Investigative Dermatology, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Michael J Wells, MD, Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center
Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association
Disclosure: Nothing to disclose.

Managing Editor

Jeffrey J Miller, MD, Associate Professor, Department of Dermatology, Penn State University, Milton S Hershey Medical Center
Disclosure: Nothing to disclose.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology
Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD, Director, Department of Dermatology, Geisinger Medical Center
Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology
Disclosure: Nothing to disclose.

 
 
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