Drug-induced bullous pemphigoid

Excerpt

A previously healthy 28-year-old man presented with a rash for 1 month. He had taken griseofulvin for a week prior to rash onset. He had visited two ERs and was given minocycline and valacyclovir, followed by acyclovir, hydroxyzine and low-dose oral steroids, with no improvement. On presentation to our clinic, he had vesicular lesions and large bullae over his forearms and thighs (Figs. 1 and 2). No mucosal lesions were present. Lab test results demonstrated WBC 10.2 K/cmm with 8.4% eosinophils. Perilesional skin biopsy showed spongiotic dermatitis with eosinophils, with direct immunofluorescence positive for subepidermal IgG and C3 depositions consistent with bullous pemphigoid. He was treated with oral prednisone and clobetasol ointment, with improvement.1

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