Linear IgA dermatosis induced by captopril / Dermatosis IgA lineal

RESUMO

Linear IgA dermatosis is an auto-immune bullous disease characterized by linear IgA deposition in the basement membrane. Most cases are idiopathicbut some are drug-related. These lack mucosal involvement, have spontaneous remission and IgA deposition clearance at the basement membraneafter drug cessation.A 89 year-old patient presenting with symmetric, itchy, tense and translucent bullous lesions located on the upper limbs and abdomen with 2 weeksevolution is reported.The patient had started captopril regimen two months before.The diagnosis was histologically confirmed. The patient started prednisolone and changed the hypertension medication from captopril to amlodipine.After 4 weeks an almost complete resolution of the lesions was observed. Prednisolone was slowly tapered and there have been no relapses for almost2 years.Skin autoimmune diseases are almost always idiopathic. However some cases can be induced or aggravated by exogenous factors including drugs,trauma, infections, vaccinations, radiographs and UV radiation[1]. Linear IgA bullous dermatosis (LABD), a rare, acquired, autoimmune, heterogeneoussubepidermal blistering disorder, is no exception[2]. Patients may present with combinations of annular or grouped papules, vesicles, and bullae.Typically, these lesions are distributed symmetrically on extensor surfaces including elbows, knees, and buttocks[2] (AU)

RESUMEN

La dermatosis IgA lineal es una enfermedad ampollosa autoinmune caracterizada por la presencia de depósitos IgA lineales en la membrana basal dela epidermis. Muchos casos son idiopáticos sin embargo otros están relacionados con fármacos, no afecta a las mucosas. Así se ha visto que al dejardichos fármacos se produce una remisión espontánea de los depósitos de la membrana basal.Hemos tenido ocasión de estudiar un varón de 89 años que presentaba lesiones ampollosas traslúcidas y tensas, pruriginosas, y de distribución simétrica,en extremidades superiores y abdomen. Pocos meses antes había comenzado tratamiento con captopril.El estudio histológico confirmó el diagnóstico y fue tratado con prednisona sustituyendo el captopril por amlodipina. Cuatro semanas mas tarde seobservó una remisión prácticamente completa de sus lesiones. La prednisolona fue retirada de forma paulatina y no ha presentado recidivas despuésde dos años (AU)