Linear IgA Bullous Dermatosis in an Elderly Patient Following Meloxicam and Candesartan Use: A Case Report

Linear immunoglobulin A (IgA) bullous dermatosis (LABD) is a rare autoimmune blistering disorder characterized by subepidermal blisters and linear IgA deposition along the dermo-epidermal junction (DEJ). We report the case of a 61-year-old woman who developed multiple tense vesicles and bullae on an erythematous base affecting both upper and lower extremities after initiating meloxicam for postoperative analgesia following knee arthroplasty. A punch biopsy showed subepidermal blistering, while direct immunofluorescence demonstrated linear IgA deposition along the basement membrane zone, confirming LABD. After discontinuation of the suspected culprit drug and adjustment of her antihypertensive therapy, she was treated with oral dapsone 1 mg/kg (50 mg) daily for two weeks, resulting in clinical improvement. This case underscores the importance of thorough drug history taking and early recognition of drug-induced LABD, particularly in patients on multiple medications, where identifying the true offending agent may be challenging.