Linear IgA bullous dermatosis: a rare side effect of vancomycin

Ann Saudi Med. 2013 Jul-Aug;33(4):397-9. doi: 10.5144/0256-4947.2012.01.7.1535. Epub 2012 Jul 1.

Abstract

Following a motor vehicle accident, a 70-year-old white female was admitted with lower limb fractures that required operative repair. The postoperative course was complicated by sepsis. Vancomycin and piperacillin/tazobactam were initiated empirically. Five days later, she developed a pruritic maculopapular rash in the groin and axilla. The rash progressed to a non-hemorrhagic vesicles and bullae on an erythematous base and spread to involve the trunk, palms and the inner aspects of the lips. Skin biopsy and direct immunofluorescence testing were consistent with vancomycin-induced linear IgA bullous dermatosis. Vancomycin was stopped with complete resolution of the lesions in the subsequent 2 weeks. Being aware of vancomycin-induced linear IgA bullous dermatosis in patients who develop a blistering skin rash while receiving this antibiotic should lead to timely interventions. Stopping vancomycin promptly and encouraging early skin biopsy to confirm the diagnosis will prevent disease progression and avoid unnecessary costs and suffering.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / therapeutic use
  • Biopsy
  • Disease Progression
  • Female
  • Fluorescent Antibody Technique, Direct
  • Humans
  • Linear IgA Bullous Dermatosis / chemically induced*
  • Linear IgA Bullous Dermatosis / diagnosis
  • Linear IgA Bullous Dermatosis / pathology
  • Postoperative Complications / drug therapy
  • Sepsis / drug therapy
  • Sepsis / etiology
  • Vancomycin / adverse effects*
  • Vancomycin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Vancomycin