Mayo Clinic Infectious Diseases
Mayo Clinic Infectious Diseases

@MayoClinicINFD

5 Tweets Apr 22, 2023
Weekend Digest
Name the condition and the most likely offending antibiotic.
@NEJM Image in Clinical Medicine by our fellow Dr. @JohnRaymondGo1 and faculty Dr. @OmarAbuSaleh15
2/
Linear #IgA bullous #dermatosis
1. Rare autoimmune disease
2. Idiopathic vs drugs - #vancomycin most common; IgA autoreactivity vs. type 7 collagen
3. Subepidermal vesicles w neutrophils and linear IgA deposits at basement membrane
#MayoIDQ MCQ next
nejm.org
3/
The medical and ID teams diagnosed the syndrome as vancomycin-induced linear IgA bullous dermatosis.
Suspecting vancomycin as the culprit, it was discontinued. In addition to supportive care, which of the following do you recommend upfront for treatment?
4/
β€œIdiopathic” linear IgA bullous dermatosis #LABD Rx
1. Dapsone - 1st line
2. Sulfa - 2nd line
3. Colchicine
4. Steroids
5. Immunosuppression for severe refractory disease (tacrolimus, MMF, others)
Rx of idiopathic LABD is often indicated!
jaoa.org
5/
Rx of drug-induced linear IgA bullous dermatosis (#LABD) is withdrawal of drug (vancomycin)!
In nearly all cases, lesions resolved within 1-3 weeks after stopping vancomycin.
Usually NO other treatment is needed (choice D is suggested answer).
jaoa.org

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