PMC8647993_01
Widespread erythematous plaques on the trunk (A). Vesicles and their evolutionary lesions on an erythematous base on a dorsal surface of a foot (B). The blisters and vesicles around the umbilicus and in the left groin (C). Deposits (indicated by arrows) of IgG1 (+) with an indeterminate pattern along the dermal-epidermal junction (epidermis is at the top of the picture) in direct immunofluorescence of perilesional skin in the periumbilical area are visualised with blue light-emitting diode technology-operated microscopy (original objective magnification x 40) (D).
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F1
The treatment with clarithromycin was discontinued after few days, as according to the mother, erythematous circular plaques started to spread from palms and soles proximally, affecting forearms, arms, shins, thighs, and the trunk (Figure 1A). Moreover, tense blisters and vesicles on the erythematous background, initially located on distal parts of upper and lower limbs (Figure 1B), were gradually spreading to the periumbilical area (Figure 1C), the whole trunk, and the face. DIF revealed linear deposits of IgG (+), IgG1 (+) (Figure 1D), and C3 (++) along the DEJ.