Korean J Dermatol.  2002 Sep;40(9):1132-1135.

A Case of Vancomycin-Induced Linear IgA Bullous Dermatosis

• Doh KS
• Kim SH
• Choi TS
• Jang MS
• Suh KS
• Kim ST

Abstract

Linear IgA bullous dermatosis(LAD) is a subepidermal blistering disease characterized by linear IgA deposits in the basement membrane zone when visualized on direct immunofluorescence microscopy. Intravenous vancomycin has been the drug most implicated, and this disease has been termed vancomycin-induced LAD. Vancomycin-induced LAD tends to spontaneously resolve upon discontinuation of the offending drug. A 70-year-old male patient developed septic knee. Bacterial cultures from this lesion grew methicillin- resistant Staphylococcus aureus. He was treated with vancomycin. Eight days after vancomycin injection, painful bullae appeared on the trunk, feet, and genitalia. A skin biopsy showed a subepidermal blister with an infiltrate composed of neutrophils and eosinophils. Direct immunofluorescence of perilesional skin showed linear IgA deposition at dermo-epidermal junction. The vancomycin was stopped; teicoplanin was substituted. He was treated with dapsone. The use of vancomycin is increasing in Korea and therefore it is important for dermatologist to be aware of the association with LAD.

Keyword

Vancomycin; Linear IgA bullous dermatosis

MeSH Terms

Aged
Basement Membrane
Biopsy
Blister
Dapsone
Eosinophils
Fluorescent Antibody Technique, Direct
Foot
Genitalia
Humans
Immunoglobulin A
Knee
Korea
Linear IgA Bullous Dermatosis*
Male
Microscopy
Neutrophils
Skin
Staphylococcus aureus
Teicoplanin
Vancomycin
Dapsone
Immunoglobulin A
Teicoplanin
Vancomycin