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GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA
A Journal on Dermatology and Sexually Transmitted Diseases
Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Giornale Italiano di Dermatologia e Venereologia 1998 February;133(1):59-62
Piperacillin-triggered pemphigus vulgaris
Guerrera V., Pinto F., Zanchini R., Ruocco E.
II Università degli Studi - Napoli, Clinica Dermosifilopatica (Direttore: Prof. V. Ruocco)
Induced pemphigus is a clinical condition provoked (induced pemphigus proper) or promoted (triggered pemphigus) by exogenous factors (provoking factors) in genetically predisposed individuals. The most important provoking factors are drugs, particularly thiol drugs (e.g. penicillamine, captopril, piroxicam), penicillin and its derivatives, pyrazolon derivatives and enalapril (a nonthiol drug which belongs to the class of ACE-inhibitors). Physical agents, viruses and tumours may also act as provoking factors. A case of pemphigus vulgaris related to administration of piperacillin (a penicillin derivative) is presented. Clinical history and features, the presence of certain HLA pemphigus-prone antigens (DR14, DQ1) in the patient’s phenotype, and the self-perpetuation of the disease after elimination of the culprit drug, suggested the diagnosis of triggered pemphigus. A sharp line of demarcation between induced and triggered pemphigus is not always possible.