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The American Society of Dermatopathology
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Case Study of the Month
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Interactive Case Study - October 2018
44-year-old with diffuse outbreak of blistering rash
Yang Li; Ilana Rosman, MD; Douglas Laurain, MD
Question 1:
A 44-year-old African American female presented to the office with approximately 2 months of multiple blisters, involving her abdomen, left ventral wrist, upper thighs and dorsal hands. The blisters were occasionally pruritic and had erupted within a few days of each other. Two punch biopsies of lesions on the right upper thigh were performed. Histopathology of lesional skin (Figures 1-3), and perilesional skin for DIF (Figure 4) reveal:
Click this image to view the virtual slide
Figure 1. 50x
Figure 2. 200x
Figure 3. 200x
Figure 4. DIF of IgA, 100x
Which of the following is the best diagnosis?
A.
Dermatitis herpetiformis
B.
Bullous pemphigoid
C.
Linear IgA bullous dermatosis
D.
Bullous systemic lupus erythematosus
E.
Epidermolysis bullosa acquisita