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Updated: Jun 1, 2026

Granulocyte-dependent Autoantibody-induced Skin Blistering

Granulocyte-dependent Autoantibody-induced Skin Blistering

Published on: October 12, 2012

A severe rash.

S Bonny¹, N Jagirdar, S Khan

¹Royal Bolton Hospital NHS Trust, Bolton, BL4 0JR.

|May 25, 2011

Summary

A patient developed a widespread rash and mouth blisters after starting sulfasalazine for rheumatoid arthritis. Discontinuation of the drug led to symptom improvement, suggesting a drug-induced hypersensitivity reaction.

Area of Science:

Rheumatology
Dermatology
Clinical Pharmacology

Background:

Sulfasalazine is a disease-modifying antirheumatic drug (DMARD) used for rheumatoid arthritis.
Drug hypersensitivity reactions can manifest with various dermatological and systemic symptoms.
Early identification and withdrawal of offending agents are crucial for managing adverse drug reactions.

Purpose of the Study:

To report a case of a potential sulfasalazine-induced hypersensitivity reaction.
To highlight the clinical presentation and diagnostic considerations in drug-induced rash.

Main Methods:

Case report of a 51-year-old male patient with rheumatoid arthritis.
Clinical examination, laboratory investigations (FBC, UEs, LFTs, CRP, ESR), and patient history including medication use.

Related Experiment Videos

Last Updated: Jun 1, 2026

Granulocyte-dependent Autoantibody-induced Skin Blistering

Granulocyte-dependent Autoantibody-induced Skin Blistering

Published on: October 12, 2012

Monitoring of symptoms following drug discontinuation.

Main Results:

The patient presented with a generalized erythematous maculopapular rash, malaise, fever, and elevated inflammatory markers (CRP 125.9, ESR 52).
Within 24 hours of discontinuing sulfasalazine, the patient developed odynophagia and mucocutaneous blistering (lips and mouth).
Symptoms were consistent with a severe cutaneous adverse drug reaction.

Conclusions:

Sulfasalazine hypersensitivity reaction should be considered in patients presenting with severe rash and systemic symptoms after initiation of the drug.
Prompt drug withdrawal is essential for managing such reactions.
This case underscores the importance of thorough medication history in diagnosing adverse drug events.