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Linear IgA Bullous Disease Presenting as Toxic Epidermal Necrolysis: A Case Report and Review of the Literature.
MedLine Citation:
PMID:  24135381     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
A 91-year-old female presented with widespread skin sloughing and bullae clinically mimicking toxic epidermal necrolysis (TEN). The patient was on multiple antibiotics, including vancomycin and piperacillin/tazobactam. Histopathology and direct immunofluorescence were consistent with a diagnosis of linear IgA bullous disease (LABD). In a PubMed review of the literature from 1975 to the present, there have been 15 cases of LABD presenting as TEN clinically and with characteristic linear IgA deposits on direct immunofluorescence studies. Vancomycin and phenytoin were the most commonly implicated medications. Twelve patients saw a resolution or healing of skin lesions after discontinuation of the implicated medication. There were, however, 5 patients who died of complications related to their comorbidities. It is important to include LABD in the differential diagnosis when evaluating patients who clinically present with TEN. © 2013 S. Karger AG, Basel.
Authors:
Rohit Kakar; Holly Paugh; Christine Jaworsky
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-11
Journal Detail:
Title:  Dermatology (Basel, Switzerland)     Volume:  -     ISSN:  1421-9832     ISO Abbreviation:  Dermatology (Basel)     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9203244     Medline TA:  Dermatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Dermatology, MetroHealth Medical Center, Case Western Reserve University, Cleveland, Ohio, USA.
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