Pemphigus drug-induced L10.5

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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drug-induced pemphigus; drug-induced pemphigus (e); medicinal pemphigus

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Pathogenetically not clearly clarified disease of the pemphigus group, which was caused by medication.

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Various drugs (especially compounds containing sulfhydryl groups such as captopril, D-penicillamine - also penicillins and cephalosporins - or gold compounds) can induce changes that correspond to the different forms of pemphigus. Non-sulfhydryl group-containing drugs such as:

pyrazolone, nifedipine, propanolol, piroxicam, phenobarbital.

In most cases (in about 90% of cases) specific pemphigus AK can be detected. In the absence of AC, acantholysis may be caused by direct reaction of the sulfhydryl groups with disulfide bridges of pemphigus antigens.

Clinical features
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Clinically indistinguishable from non-drug pemphigus diseases. Picture of pemphigus vulgaris, pemphigus foliaceus, pemphigus herpetiformis.

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After discontinuation of the drugs (especially those containing non-sulfhydryl groups) healing may occur spontaneously. However, clinical experience shows that regular treatment of pemphigus disease is necessary.

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S.a. Lupus erythematosus, drug-induced. With long-term use of D-penicillamine (> 6 months) a 6% probability of pemphigus induction can be expected.

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  1. Ayoub N (2005) Pemphigus and pemphigus-triggering drugs. Ann Dermatol Venereol 132: 595
  2. Sugita K et al (2004) D-penicillamine-induced pemphigus successfully treated with combination therapy of mizoribine and prednisolone. J Dermatologist Treat 15: 214-217
  3. Goldberg I et al (2005) Pemphigus vulgaris triggered by glibenclamide and cilazapril. Acta Dermatovenerol Croat 13: 153-155
  4. Tang X et al (2012) Drug-induced pemphigus after six years of treatment withphenytoin
    and carbamazepine. Int J Dermatol 51:485-486

  5. Yoshimura K et al (2014) Clinical and immunological profiles in 17 Japanese patients
    with drug-induced pemphigus studied at Kurume University. Br J Dermatol 171:544-553


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Last updated on: 29.10.2020