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Yoshimura et al. set out to characterize the clinical and immuno logical profiles of patients with drug-induced pemphigus. They studied 17 Japanese patients with druginduced pemphigus diagnosed between 1997 and 2012. They recorded clinical and histopathological manifestations, responsible drugs, immunofluorescence findings, enzymelinked immunosorbent assay (ELISA) and immunoblotting (IB) results and clinical outcome. Eight of the 17 patients with drug-induced pemphigus showed pemphigus foliaceuslike appearance, three showed pemphigus herpetiformislike appearance and six showed atypical bullous lesions. The drugs implicated were thiol containing in 16 patients and nonthiol containing in one patient. By ELISA and/ or IB analyses, nine patients reacted only with desmoglein (Dsg)1, four reacted with Dsg1 and Dsg3, and four showed no specific reactivity. Four patients with no detectable malignancy showed positive reactivity to Dsg1, and paraneoplastic pemphigus-like reactivity with the 210-kDa envoplakin and 190-kDa periplakin. Eleven patients were reported to have recovered following discontinuation of the causative drugs. However, six patients had a very protracted or intractable disease course. The authors concluded that the majority of their cases showed a phenotype resembling pemphigus foliaceus, with anti-Dsg1 autoantibodies caused by thiolcontaining drugs. Br J Dermatol 2014; 171: 544–553.