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Drug-Induced Pemphigus

Background

Pemphigus is an autoimmune bullous disease characterized by blisters and erosions of the skin and mucous membranes. Several variants of the disease exist, including pemphigus vulgaris, pemphigus foliaceous, and drug-induced pemphigus. Patients with drug-induced pemphigus have autoantibodies that are either circulating or tissue bound.
Since the 1950s, evidence has grown that drugs may cause or exacerbate pemphigus. A drug origin should be considered in every new patient with pemphigus. The most common variant of pemphigus associated with drug exposure is pemphigus foliaceus, although pemphigus vulgaris has also been described. In penicillamine-treated patients, pemphigus foliaceus is more common than pemphigus vulgaris, with an approximate ratio of 4:1.

Note the images below.

Early small blister filled with clear fluid arises

Early small blister filled with clear fluid arises on healthy skin.

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Flaccid blister filled with clear fluid arises on

Flaccid blister filled with clear fluid arises on healthy skin.

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An erosion.

An erosion.

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