A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis

Linear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vanco...

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Main Authors: Pinky Jha, Kurtis Swanson, Jeremiah Stromich, Basia M. Michalski, Edit Olasz
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Dermatological Medicine
Online Access:http://dx.doi.org/10.1155/2017/7318305
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author Pinky Jha
Kurtis Swanson
Jeremiah Stromich
Basia M. Michalski
Edit Olasz
author_facet Pinky Jha
Kurtis Swanson
Jeremiah Stromich
Basia M. Michalski
Edit Olasz
author_sort Pinky Jha
collection DOAJ
description Linear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister) formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations.
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series Case Reports in Dermatological Medicine
spelling doaj-art-067f1f9b343d4b49b0407d46983539db2025-08-20T02:03:40ZengWileyCase Reports in Dermatological Medicine2090-64632090-64712017-01-01201710.1155/2017/73183057318305A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous DermatosisPinky Jha0Kurtis Swanson1Jeremiah Stromich2Basia M. Michalski3Edit Olasz4Section of Hospital Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, WI, USAMedical College of Wisconsin, Milwaukee, WI, USAMedical College of Wisconsin, Milwaukee, WI, USAMedical College of Wisconsin, Milwaukee, WI, USADepartment of Dermatology, Medical College of Wisconsin, Milwaukee, WI, USALinear IgA bullous dermatosis (LABD) is an autoimmune vesiculobullous disease, which is typically idiopathic but can also rarely be caused by medications or infections. Vancomycin is the most common drug associated with LABD. Lesions typically appear 24 hours to 15 days after the first dose of vancomycin. It is best characterized pathologically by subepidermal bulla (blister) formation with linear IgA deposition at the dermoepidermal junction. Here we report an 86-year-old male with a history of left knee osteoarthritis who underwent a left knee arthroplasty and subsequently developed a prosthetic joint infection. This infection was treated with intravenous vancomycin as well as placement of a vancomycin impregnated joint spacer. Five days following initiation of antibiotic therapy, he presented with a vesiculobullous eruption on an erythematous base over his trunk, extremities, and oral mucosa. The eruption resolved completely when intravenous vancomycin was discontinued and colchicine treatment was begun. Curiously, complete resolution occurred despite the presence of the vancomycin containing joint spacer. The diagnosis of vancomycin-induced linear IgA bullous dermatosis was made based on characteristic clinical and histopathologic presentations.http://dx.doi.org/10.1155/2017/7318305
spellingShingle Pinky Jha
Kurtis Swanson
Jeremiah Stromich
Basia M. Michalski
Edit Olasz
A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
Case Reports in Dermatological Medicine
title A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
title_full A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
title_fullStr A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
title_full_unstemmed A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
title_short A Rare Case of Vancomycin-Induced Linear Immunoglobulin A Bullous Dermatosis
title_sort rare case of vancomycin induced linear immunoglobulin a bullous dermatosis
url http://dx.doi.org/10.1155/2017/7318305
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