A 70-year-old man presents with tense, intact blisters arising on urticarial plaques on the flexural areas and abdomen. Oral mucosa is spared. Nikolsky sign is negative. DIF shows linear IgG and C3 deposition at the dermo-epidermal junction. On electron microscopy, immune deposits are found in the lamina lucida. The drug most commonly implicated in triggering a drug-induced form of this condition is:
- A Penicillamine
- B Furosemide
- C Captopril
- D Furosemide and other loop diuretics ✓
Explanation
Bullous pemphigoid (BP) targets BP180 (NC16A domain) and BP230 at the hemidesmosome, producing tense sub-epidermal blisters with immune deposits in the lamina lucida. The Nikolsky sign is negative because acantholysis does not occur. Drug-induced BP is most commonly triggered by loop diuretics (furosemide), followed by neuroleptics (e.g., spironolactone, phenacetin) and certain antibiotics. Penicillamine more classically induces drug-induced pemphigus (acantholytic), not BP. Furosemide is the single most frequently reported culprit in drug-induced BP in published series.
Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.