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Bullous pemphigoid developing during systemic therapy with chloroquine
T P Millard1, H R Smith, M M Black
1St John's Institute of Dermatology, St Thomas' Hospital, London, UK.
Clinical and Experimental Dermatology
|August 24, 1999
Summary
Bullous pemphigoid can be triggered by medications. This case highlights chloroquine as a potential cause, presenting with unusual skin lesions similar to erythema multiforme.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Bullous pemphigoid is an autoimmune blistering disease.
- Drug-induced bullous pemphigoid is a known but less common presentation.
- Several medications have been implicated in its development.
Observation:
- A patient with sarcoidosis developed generalized pruritus and a widespread bullous eruption.
- The eruption featured acral targetoid lesions, clinically resembling erythema multiforme.
- The patient was undergoing treatment with chloroquine for sarcoidosis-related dyspnea.
Findings:
- Histological and immunofluorescence examinations confirmed bullous pemphigoid.
- The clinical presentation was atypical, with features mimicking erythema multiforme.
- Chloroquine was identified as the likely precipitating agent.
Implications:
- This case expands the spectrum of clinical presentations for drug-induced bullous pemphigoid.
- Highlights the importance of considering chloroquine in the differential diagnosis of drug-induced blistering diseases.
- Suggests that atypical presentations of bullous pemphigoid may occur with certain drug therapies.