Linear IgA dermatosis after infliximab infusion for ulcerative colitis

IBD: inflammatory bowel disease LAD: linear IgA dermatosis TNF: tumor necrosis factor UC: ulcerative colitis INTRODUCTION Linear IgA dermatosis (LAD) is an idiopathic or drug-induced autoimmune subepidermal blistering disease characterized by linear deposition of IgA antibodies along the dermoepidermal junction. The pathogenesis, although incompletely understood, involves the formation of dermal papillary microabscesses that lead to subepidermal clefts and blistering. The tissue injury likely results in part from the release of proteolytic enzymes by neutrophils composing the abscess. LAD can occur in both children and adults, with lesions classically described as round or oval vesicles or bullae on normal, erythematous, or urticarial skin. Definitive diagnosis requires the use of direct immunofluorescence to show the distinctive band of IgA at the dermoepidermal junction. In most cases of LAD, the inciting factor is unknown, although several reports implicate various medications in the development of the disease. Vancomycin is the most frequently reported medication in drug-induced LAD, with nonsteroidal anti-inflammatory agents, penicillins, cephalosporins, and captopril also commonly cited. Herein, we present an uncommon case of LAD after the administration of the antietumor necrosis factor (TNF) monoclonal antibody, infliximab.