Vancomycin-induced linear IgA bullous disease presenting as toxic epidermal necrolysis

Clin Exp Dermatol. 2004 Nov;29(6):633-6. doi: 10.1111/j.1365-2230.2004.01649.x.


Linear IgA bullous dermatosis (LABD) is a rare autoimmune vesiculobullous disorder characterized by variable clinical presentations that may mimic bullous pemphigoid, dermatitis herpetiformis, cicatricial pemphigoid and erythema multiforme. A few cases of drug-induced LABD that clinically resembled toxic epidermal necrolysis (TEN) have been reported. A subset of patients with LABD have been found to be drug-induced; the most common drug being vancomycin. The diagnosis of LABD is confirmed by the presence of a linear band of IgA along the basement membrane zone on direct immunofluorescence microscopy. We report a case of a 77-year-old man who presented to us with vancomycin-induced LABD that presented clinically as TEN. He had a complete recovery over a 3-week period following discontinuation of the vancomycin and the addition of oral dapsone therapy. It is important to be aware that drug-induced LABD can mimic TEN.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged
  • Anti-Bacterial Agents / adverse effects
  • Autoimmune Diseases / chemically induced*
  • Autoimmune Diseases / diagnosis
  • Diagnosis, Differential
  • Humans
  • Immunoglobulin A / analysis
  • Male
  • Skin Diseases, Vesiculobullous / chemically induced*
  • Skin Diseases, Vesiculobullous / diagnosis
  • Stevens-Johnson Syndrome / diagnosis
  • Stevens-Johnson Syndrome / etiology*
  • Vancomycin / adverse effects*


  • Anti-Bacterial Agents
  • Immunoglobulin A
  • Vancomycin