A subepidermal blistering disorder
A young woman presented with generalised tense blisters. There had been no previous drug exposure and she had no clinical signs of autoimmune disease or evidence of sepsis. Given the abrupt onset and clinical scenario, a skin punch biopsy was performed and a tentative diagnosis of linear IgA bullous dermatosis (LABD) was made. Dapsone, an immunomodulatory sulfone that has been supported for use in LABD by case reports and clinical observation, was administered with an adjunctive oral corticosteroid to accelerate resolution. The biopsy findings were supportive of a subepidermal blistering disorder, such as linear IgA bullous dermatosis. After just 5 days of therapy, dramatic improvement was noted and she continued to improve. LABD is an uncommon condition, with incidence rates reported to be ranging from less than 0.5 to 2.3 cases per million individuals per year.
Yusuf Moolla, Department of Internal Medicine, Addington Hospital, Durban, South Africa
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Date published: 2016-02-22
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