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Captopril-induced pemphigus vegetans with Charcot-Leyden crystals
Journal of the American Academy of Dermatology
|August 1, 1992
Summary
Captopril medication may induce pemphigus vegetans, a rare skin condition. This case report details a patient whose lesions resolved after discontinuing captopril, suggesting a drug-induced etiology.
Area of Science:
- Dermatology
- Immunodermatology
- Pharmacology
Background:
- Pemphigus vegetans is a rare autoimmune blistering disease characterized by vegetating plaques.
- Drug-induced pemphigus is an uncommon but recognized phenomenon.
- Captopril is an angiotensin-converting enzyme inhibitor used to treat hypertension and heart failure.
Observation:
- A 78-year-old woman presented with intertriginous vegetating plaques, oral ulcers, and a cerebriform tongue after 11 months of captopril therapy.
- Clinical, histological, and immunofluorescence findings were consistent with pemphigus vegetans.
- Charcot-Leyden crystals were noted in intraepidermal eosinophilic abscesses.
Findings:
- The patient was diagnosed with pemphigus vegetans.
- The skin lesions showed rapid improvement and clearance upon cessation of captopril.
- This represents the first documented case of captopril-induced pemphigus vegetans.
Implications:
- Captopril should be considered as a potential causative agent in drug-induced pemphigus vegetans.
- Early recognition and withdrawal of the offending drug are crucial for patient management.
- This case highlights the importance of a thorough medication history in diagnosing unusual dermatological conditions.