The pattern of immunostaining with antibodies to desmoglein can help identify separate patients who will probably recover from those who will probably not once the implicated drug is discontinued.


A large number of drugs have been implicated in causing drug-induced pemphigus:

(1) some contain a thiol group

(2) some have metabolites with a thiol group

(3) some contain a pyrazol group

(4) some are antibiotics

(5) others (diverse group)


There may be a time interval between when a person was given the drug and the appearance of the skin lesions. Since some of these drugs are widely used the relationship can become tenuous.


Antibody used for immunostaining: to desmogleins 1 and 3 (monoclonal 32-2B)




fine dots along the cytoplasmic membranes; a darker band is seen below the stratum corneum on low power


coarse granules along the cytoplasmic borders of keratinocytes; may be found in cells of adnexal structures (hair follicles and sweat glands)


84% of patients with idiopathic pemphigus show a patchy pattern.


70% of patients with drug-induced pemphigus have a normal pattern. Most of these patients will recover if the implicated drug is discontinued.


30% of patients with drug-induced pemphigus have a patchy pattern. Most of these do not recover if the implicated drug is discontinued.


NOTE: There is a divergence between the data in Table 4 and the results given in column 1 on page 373 (in Table 4 there are 37 people with drug-induced pemphigus while in the text the numbers add up to 26).


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