Content » Vol 86, Issue 5

Clinical Report

Penicillin-induced Anti-p200 Pemphigoid: An Unusual Morphology

Katarzyna Wozniak, Cezary Kowalewski, Takashi Hashimoto, Norito Ishii, Maria Glinska-Wielochowska and Robert A. Schwartz
DOI: 10.2340/00015555-0117

Abstract

We report here a case of a 52-year-old woman with ery­thema gyratum repens-like lesions appearing during anti-p200 pemphigoid, probably induced by oral penicillin. The diagnosis of anti-p200 pemphigoid was made by the presence of in vivo bound and circulating IgG anti-base­ment membrane zone auto-antibody reactive with the
dermal side of salt-split skin and with 200 kDa protein in dermal extract on Western immunoblot. Laser scanning confocal microscopic study disclosed the localization of IgG at the lamina lucida-lamina densa border. Skin lesions responded poorly to high dose of prednisone and the combination of prednisone and dapsone. When methotrexate was added, skin lesions healed within 3 weeks. To our knowledge, erythema gyratum repens-like lesions have not been described previously in this disorder. Thus, we have expanded the clinical morphological spectrum of patients with anti-p200 pemphigoid and first described a patient whose disorder was probably drug-induced.

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