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Bullous pemphigoid mimicking bullous erythema multiforme: an untoward side effect of penicillins
1Department of Dermatology, Beilinson Medical Center, Petah Tiqva, Israel.
Abstract:
Three young and middle-aged patients developed severe bullous eruption after receiving various penicillins. The clinical findings included high fever, prostration, widespread bullous eruption mainly on the head, face, and extremities, targetlike lesions on the palms and soles, and severe erosions in almost all the mucous membranes. Direct and indirect immunofluorescence studies were those of bullous pemphigoid. Complete clearing of the eruption occurred with prednisone therapy. We conclude that drug-induced bullous pemphigoid is a different entity from the classic bullous pemphigoid.
Insights
Severe skin reactions, including widespread blisters and mucous membrane erosions, occurred in three patients after penicillin use. These cases suggest a distinct form of drug-induced bullous pemphigoid treatable with prednisone.
Area of Science:
- Dermatology
- Immunology
- Pharmacology
Background:
- Antibiotics, particularly penicillins, are widely prescribed.
- Adverse drug reactions can manifest with severe dermatological symptoms.
- Bullous pemphigoid is an autoimmune blistering disease.
Observation:
- Three patients developed severe bullous eruptions following penicillin administration.
- Clinical presentation included high fever, prostration, widespread blistering (head, face, extremities), targetoid lesions (palms, soles), and severe mucosal erosions.
- Immunofluorescence studies were consistent with bullous pemphigoid.
Findings:
- The observed bullous eruption appears to be a distinct entity from classic bullous pemphigoid.
- Prompt treatment with prednisone resulted in complete clearing of the eruption in all patients.
Implications:
- This study highlights a specific drug-induced bullous pemphigoid associated with penicillin.
- Early recognition and appropriate management with corticosteroids are crucial for favorable outcomes.
- Distinguishing drug-induced bullous pemphigoid from the classic form is important for patient care.