The cases of bullous eruption of systemic lupus erythematosus in this study were two females. They were the age of 18 and 15. Both of them met ARA criteria for a diagnosis of SLE, and the eruptions developed long after the diagnosis. In both cases bullae were presented on the face, neck and upper extremities. Administration of dapsone showed complete clearing of lesions within several days. Routine histology of the lesion showed subepidermal blisters, an intact epidermis, ancl neutrophilic microabscess in dermal papillae. Direct munofluorescence of perilesional and normal forearm skin showed coarse linear pattern of immune deposits at the basement membrane zone in both cases. Circulating anti-basement membrane zone IgG auto-antibodies were detected at a titer of 1: 32 and 1: 16 in each case on NaC1 separated skin substrates.
Basement Membrane ; Blister ; Connective Tissue Diseases* ; Connective Tissue* ; Dapsone ; Diagnosis ; Epidermis ; Female ; Forearm ; Humans ; Immunoglobulin G ; Lupus Erythematosus, Systemic* ; Membranes ; Neck ; Neutrophils ; Skin ; Upper Extremity

BACKGROUND: The abuse, misuse, and adverse effects to topical drugs have been widespread in Korea due to lack of awareness of seriousness of drug abuse and misuse, and improper designation of prescription and non-prescription drugs. OBJECTIVE: This study was conducted to bring Korean people to an awareness of the abuse, misuse, and adverse effects of topical drugs, and to stress the importance of proper designation of non-prescription drugs. METHODS: A multicenter, prospective, clinico-epidemiologic evaluation was made from patients with adverse effects to topical drugs who visited 31 dermatologic departments in university hospitals or private clinics nationwide from march, 2002 to December, 2002. RESULTS: The diagnostic incidence of adverse effects from topical drugs are abuse and misuse (40%), dermatophytosis incognito (29%), bacterial infection (14%), contact dermatitis (9%), acne (2.5%), skin atrophy (1.4%), telangiectasia (1%). Erghty three percent of adverse effects are caused by topical corticosteroids, and betamethasone valerate, prednicarbate and triamcinolone acetonide are commonly used topical corticosteroids that induce adverse effects frequently. The most common way to obtain topical drugs is purchase directly from pharmacist without prescriptions. CONCLUSION: From this study, we confirmed that adverse effects to topical corticosteroids are very common even after the enforcement of designation of prescription drugs and non-prescription drugs. The proper designation of prescripton drugs should be reevaluated and based on the safety of patients to protect people from adverse effects of topical drugs.
Acne Vulgaris ; Adrenal Cortex Hormones ; Atrophy ; Bacterial Infections ; Betamethasone Valerate ; Dermatitis, Contact ; Hospitals, University ; Humans ; Incidence ; Korea ; Nonprescription Drugs ; Pharmacists ; Prescription Drugs ; Prescriptions ; Prospective Studies ; Skin ; Substance-Related Disorders ; Telangiectasis ; Tinea ; Triamcinolone Acetonide