PMC10392149_01
Bilateral erythematous plaques with hemorrhagic and erosive lesions on the lower extremities of the patient (the bright red color is due to the usage of eosin solution).
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A 32-year-old male patient with no past medical or drug history presented with manipulated hemorrhagic bullae and erosive lesions with a sharply circumscribed margin on both of his lower extremities (Figure 1).
Biopsy specimen from a lesional bulla. Denuded skin without the epidermis and superficial dermal inflammatory infiltrate composed of lymphocytes and eosinophils (original magnification (a): x40, (b): x10).
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Microscopic descriptions showed a skin tissue with separation of the denuded epidermis from the underlying dermis and mixed dermal infiltration composed of predominantly eosinophils, some lymphocytes, and neutrophils with dilated vessels and superficial fibrosis (Figure 2).
Direct immunofluorescence of the perilesional skin showing continuous linear deposition of IgG and C3 along the dermo-epidermal junction.. IgG: immunoglobulin G.
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Direct immunofluorescence found linear deposition of IgG antibodies in the basement membrane (Figure 3).