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[D-penicillamine-induced pemphigus: changes in anti-32-2B immunostaining patterns]
M Khashoggi1, L Machet, A Perrinaud
1Service de dermatologie, université François-Rabelais, CHRU, 37044 Tours cedex 9, France.
Annales De Dermatologie Et De Venereologie
|September 17, 2013
Summary
D-penicillamine can induce pemphigus, which may transition from drug-induced to autoimmune. Changes in anti-32-2B antibody staining indicate this shift, suggesting a poorer prognosis even after drug cessation.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- D-penicillamine is known to induce superficial pemphigus.
- Immunostaining with anti-32-2B antibody aids in differentiating drug-induced from autoimmune pemphigus.
- Absence of staining suggests drug-induced pemphigus, while positive staining indicates ongoing autoimmune activity.
Observation:
- A patient treated with D-penicillamine developed superficial pemphigus.
- Initial anti-32-2B antibody staining was normal, consistent with drug-induced pemphigus.
- Pemphigus recurred after D-penicillamine discontinuation, with subsequent abnormal staining indicating autoimmune pemphigus.
Findings:
- Drug-induced pemphigus can evolve into autoimmune pemphigus.
- Changes in anti-32-2B antibody staining patterns reflect this transition.
- Abnormal staining post-drug cessation signifies a risk of chronic disease.
Implications:
- Monitoring anti-32-2B antibody staining is crucial for predicting pemphigus prognosis.
- This case highlights the potential for drug-induced pemphigus to become chronic and autoimmune.
- Understanding these changes can guide treatment strategies for persistent pemphigus.
