Drug-Induced

  • Interval of onset = weeks to months
  • Remission after drug discontinued (most)
  • 35-50% remit spontaneously
  • Nonthiol drugs → more chronic course

2 groups of drugs:

  1. Non-thiol drugs with or without sulfur e.g. penicillins, cephalosporins, piroxicam, etc. likely induce acantholysis by antibody generation
  2. Thiol drugs (most common)
    • Penicillamine (#1)
    • Captopril
    • Enalapril
    • MOA: Induce acantholysis directly without antibody formation possibly by interfering directly with desmosomal protein function

  • Most commonly PF > PV presentation = 4:1 ratio
  • Thiol drugs → PF
  • Non-thiol drugs → PV
  • Similar complications

As PF or PV above (see respective subsections)

  • Stop culprit drug #1.
  • Depending on severity symptomatic management until remission or treat as PF/PV above.

  • No information Available