A case of vancomycin-associated linear IgA bullous dermatosis and IgA antibodies to the α3 subunit of laminin-332

Br J Dermatol. 2014 Apr;170(4):965-9. doi: 10.1111/bjd.12720.

Abstract

Linear IgA bullous dermatosis (LABD) is a rare autoimmune bullous disease, which is defined by the histopathological finding of subepidermal vesicles with neutrophilic infiltration and linear IgA deposits in the basement membrane zone, revealed by immunofluorescence study. We present a case of LABD in which vancomycin (VCM) administration triggered LABD, and immunoblot analysis showed IgA antibodies reactive to the 145- and 165-kDa α3 subunits of laminin-332. This is the first report of VCM-associated LABD in which the target antigen was laminin-332. In the present case, we were compelled to continue administration of VCM along with systemic steroids, which eventually led to the attenuation of the symptoms, normalization of the serum IgA level, and negative results on both indirect immunofluorescence of 1 mol L(-1) NaCl-split skin and immunoblot analysis.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Antibodies / immunology
  • Drug Eruptions / etiology
  • Drug Eruptions / immunology
  • Endocarditis, Bacterial / drug therapy
  • Humans
  • Immunoglobulin A / immunology
  • Laminin / immunology*
  • Linear IgA Bullous Dermatosis / chemically induced*
  • Linear IgA Bullous Dermatosis / immunology
  • Male
  • Middle Aged
  • Vancomycin / adverse effects*

Substances

  • Anti-Bacterial Agents
  • Antibodies
  • Immunoglobulin A
  • Laminin
  • laminin alpha 3
  • Vancomycin