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Lichen planus pemphigoides associated with Chinese herbs
1Department of Dermatology, No. 1 Hospital of China Medical University, Shenyang, China.
Clinical and Experimental Dermatology
|August 14, 2008
Summary
This case study details a rare instance of lichen planus pemphigoides (LPP) triggered by oral Chinese herbs in a 62-year-old woman. It highlights a potential adverse reaction to herbal medicine, leading to a severe autoimmune blistering condition.
Area of Science:
- Dermatology
- Immunodermatology
- Integrative Medicine
Background:
- Lichen planus (LP) is a common inflammatory condition affecting skin and mucous membranes.
- Lichen planus pemphigoides (LPP) is a rare variant characterized by features of both LP and bullous pemphigoid (BP).
- Traditional Chinese medicine (TCM) use is widespread, but potential adverse dermatological effects require further investigation.
Observation:
- A 62-year-old Chinese woman with a 2-year history of LP developed extensive skin lesions after consuming oral Chinese herbs.
- The patient presented with violaceous maculopapules and plaques, followed by vesiculobullous lesions.
- Histopathology revealed subepidermal blisters and bandlike lymphocytic infiltration.
Findings:
- Direct immunofluorescence showed linear IgG and C3 deposits at the basement membrane zone.
- Indirect immunofluorescence demonstrated IgG antibodies on the epidermal side of salt-split skin.
- Elevated circulating anti-BP180 antibodies confirmed via ELISA.
Implications:
- This case represents the first reported instance of LPP associated with oral Chinese herbal preparation.
- It underscores the importance of considering iatrogenic causes, including herbal remedies, in the differential diagnosis of LPP.
- Clinicians should maintain a high index of suspicion for drug-induced or herb-induced dermatoses, particularly in patients with pre-existing inflammatory skin conditions.