[Bullous pemphigoid induced by spironolactone].

INTRODUCTION

The role of spironolactone as pemphigoid-inducing agent has recently been suggested. We report a new case of pemphigoid probably induced by spironolactone. The disease resolved after withdrawal of the diuretic drug containing aldactone.

OBSERVATION: A 76 year-old patient was hospitalized for eczematiform lesions and severe pruritus. Histological and immunological investigations led to the diagnosis of pemphigoid. For several years, the patient had been treated with acarbose, amlodipine, fluvastatine, buflomedil, lysine acetylsalicylate and a spironolactone-furosemide association. On withdrawal of spironolactone alone, the cutaneous lesions regressed spontaneously within 15 days and no relapse was noted 30 months later.

DISCUSSION: Numerous observations have suggested the role of certain drugs in the occurrence of pemphigoid. A recent test case study concerning drugs administered to patients suffering from pemphigoid has shown the significant association with spironolactone and neuroleptics. In our case report, the imputability of spironolactone is plausible. Because of the poor prognosis of pemphigoid, essentially due to iatrogenic complications, it is valuable to be able to delay the initiation of specific treatment for a few days, in patients receiving spironolactone.