BULLOUS PEMPHIGOID INDUCED BY SPIRONOLACTONE

Background. Sporadic observations would suggest that certain drugs pla y a role in the development of pemphigoid. A recent case-control study on long-term drug use associated with pemphigoid was unable to confir m the suspected role of these drugs, but did demonstrate a significant association between the development of pemphigoid and use of spironol actone. Case report. An 82-year-old patient had bullous erythematous l esions on the left thigh suggestive of pemphigoid. Histology and direc t cutaneous immunofluorescence confirmed the diagnosis. The patient ha d been taking alimemazine, adrafinil, flunarizine, spironolactone and furosemide as long-term treatment. Spironolactone alone was withdrawn. The cutaneous lesions regressed and have not recurred during the 18-m onth follow-up. Discussion. The causal effect of spironolactone in thi s case of pemphigoid is quite plausible. This hypothesis is favored by the agreement with epidemiological data. Other observations are howev er required before the causal role of spironolactone in the developmen t of pemphigoid can be confirmed.