PMC9314756_01
(A) On admission, urticarial erythema and papules on the trunk and extremities. Isolated tense blisters and bullae on the abdomen and bilateral thighs (B and C) erythema on the back and lower limbs progressed, with more new vesicles continuing to appear on the legs. (D) Erythema transformed into hyperpigmentation.
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Isolated tense blisters and bullae could be observed on the abdomen and bilateral thighs (Figure 1A). Erythema on the back and lower limbs progressed, with more new vesicles continuing to appear on the legs (Figure 1B and C). On the 2nd dose of omalizumab, the patient only had slight itching, and the erythema transformed into hyperpigmentation (Figure 1D).
Pathology of skin biopsy from the lesions on the left thigh showed subepidermal blister formation with eosinophilic infiltrate, dermal vascular proliferation with lymphocytes, and eosinophil infiltration. (A) Magnification x40, (B) magnification x 100, (C) magnification x 200, (D) magnification x 200.
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Histopathological examination from a skin biopsy of the left thigh demonstrated subepidermal blister formation with eosinophilic infiltrate, dermal vascular proliferation with lymphocytes, and eosinophil infiltration (Figure 2).