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Updated: Aug 16, 2026

Granulocyte-dependent Autoantibody-induced Skin Blistering
Published on: October 12, 2012
Clinical Characteristics, Treatment, and Outcomes of Vancomycin-Induced Linear IgA Bullous Dermatosis
Zhaoquan Wu1,2, Wei Sun3, Chunjiang Wang4,5
1College of Pharmacy, Changsha Medical University, Changsha, China.
Introduction:
This study aimed to elucidate the clinical attributes of vancomycin-induced linear IgA bullous dermatosis (LABD) to enhance diagnostic, therapeutic, and preventive approaches.
Methods:
We conducted a retrospective analysis of vancomycin-induced LABD cases by reviewing the literature in Chinese and English databases up to July 31, 2025.
Results:
A total of 104 patients were identified for the retrospective analysis, with a median age of 70 years (range 29, 92). The median time to onset of LABD was 9 days (range 0.5, 20), with 80.7% of patients presenting symptoms within 2 weeks. The predominant clinical manifestations included blisters (87.1%), vesicles (41.3%), erythema (52.9%), and papules (19.2%), frequently accompanied by pruritus (18.3%). Mucosal involvement was noted in 26.9% of cases. Histopathological examination typically demonstrated inflammatory cell infiltration (79.8%). Direct immunofluorescence assays revealed linear IgA deposition along the basement membrane zone. After stopping vancomycin and receiving treatment, all patients exhibited significant improvement in their skin lesions.
Conclusion:
Clinicians should recognize LABD as a serious but infrequent adverse reaction to vancomycin. Increased vigilance is crucial during the initial 2 weeks of vancomycin treatment, especially in elderly patients over 60 years of age. LABD recovered completely after withdrawal of vancomycin and other treatments.
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