Intravenous immunoglobulin-induced, non-eczematous, vesiculobullous eruptions in Stevens-Johnson syndrome

Am J Clin Dermatol. 2009;10(5):339-42. doi: 10.2165/11310610-000000000-00000.

Abstract

Intravenous immunoglobulin (IVIG) has emerged as a promising treatment that interrupts the progression of Stevens-Johnson syndrome (SJS). Our patient experienced an uncommon adverse effect, non-eczematous, vesiculobullous eruptions, after treatment with IVIG. These new lesions developed rapidly on the palms while most previous SJS bullous lesions subsided. A skin biopsy of these new lesions showed an intracorneal vesicle, without epidermal necrosis, with inflammatory cell infiltration. IVIG-induced, vesiculobullous eruptions are discussed, along with their possible pathogenesis. With the increasing use of IVIG for treatment of bullous dermatoses, recognition of this rare adverse effect is important for prompt differential diagnosis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • Female
  • Hand Dermatoses / chemically induced
  • Hand Dermatoses / diagnosis
  • Humans
  • Immunoglobulins, Intravenous / adverse effects*
  • Immunoglobulins, Intravenous / therapeutic use
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use
  • Middle Aged
  • Skin Diseases, Vesiculobullous / chemically induced*
  • Skin Diseases, Vesiculobullous / diagnosis
  • Stevens-Johnson Syndrome / drug therapy*

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors