PURPOSE OF REVIEW This review presents the current knowledge of the role of T cells in drug allergy manifesting as exanthematous, pustular and bullous skin diseases, collectively referred to as nonimmediate allergic drug reactions. RECENT FINDINGS Both CD4+ and CD8+ T cells producing type 1 and type 2 cytokines and endowed with cytotoxic properties are involved in nonimmediate allergic drug r...

Subepidermal blistering associated with the human skin diseases bullous pemphigoid and herpes gestationis has been thought to be an IgG autoantibody-mediated process; however, previous attempts to demonstrate the pathogenicity of patient autoantibodies have been unsuccessful. An immunodominant and potentially pathogenic epitope associated with these blistering diseases has recently been mapped ...

Pemphigoid is a group of bullous diseases that have a diversified morphologic presentation and affects skin, oral mucosa and other mucosal membranes alone or in combination. In the literature, the condition has been subclassified into bullous pemphigoid and cicatricial pemphigoid (Mucous membrane pemphigoid) on the basis of primary organ of involvement. Oral pemphigoid, defined as cicatricial p...

A 9-year-old boy presented with itching and bulla formation since the last 3 years. The lesions commenced over the abdomen, scalp and then became generalized. Past perinatal and drug history were uneventful. On examination, tense bullae (0.5 cm to 3.5 cm in diameter) were present all over the body (Fig. 1). Bullae arranged in an annular pattern were seen in perineal region (string of pearl’s si...

A 12 year old boy suffering from p67-phox deficient chronic granulomatous disease presented with a bullous skin disease and a lung infection with paecilomyces species. The histopathology of a bullous lesion showed subepidermal blister formation and microabcesses containing eosinophils in the dermal papillae. By direct immunofluorescence, linear staining of IgA at the dermal-epidermal junction w...

Bullous lesions in patients with end-stage renal disease are uncommon and can pose diagnostic and therapeutic challenges. We present a female patient with end-stage renal disease, bullous skin lesions affecting mainly sun-exposed areas, and high ferritin levels. She also had hepatitis C. Her serum porphyrin panel was suggestive of porphyria cutanea tarda. Skin biopsy excluded inflammatory patho...

The detection of autoantibodies to epidermal or basement membrane zone proteins by immunoblot (IB) is useful for the diagnosis and the classification of autoimmune bullous diseases (AIBD). IB using human skin extracts is actually the reference method but A431 cell line is proposed as easier alternate antigen source. We explored the performances of “A431 IB” in comparison with the reference tech...

Diffuse cutaneous mastocytosis, the most rare form of cutaneous mastocytosis, often manifests as bullous lesions. Although cutaneous mastocytosis should be included in a differential diagnosis for pruritic skin lesions in children, early diagnosis of the disease is not easy due to its rare occurrence. A 17-month-old boy presented with recurrent itchy bullous skin lesions. He had been treated as...