Ramipril-associated lichen planus pemphigoides.
Ogg GS., Bhogal BS., Hashimoto T., Coleman R., Barker JN.
We report the first case of lichen planus pemphigoides (LPP) secondary to ingestion of ramipril, an angiotensin-converting enzyme inhibitor. Clinical, histological and immunofluorescent findings were all consistent with a diagnosis of LPP. Linear basement membrane zone (BMZ) staining with IgG and C3 was only seen at the roof of split-skin preparations and circulating autoantibody to the BMZ was present at a titre of 1/100. Controlled immunoblotting of epidermal extracts detected the bullous pemphigoid antigens of 230 and 180 kDa.