PMC4809475_01
Few tense, clear, fluid-filled vesicles and bullae on the (A) right preauricular area, (B) chest, and (C) sole of right foot.
gr1.jpg
PMC4809475_01_gr1.jpg
fig1
Philippines. Physical examination found a few tense, clear fluid-filled vesicles and bullae on the right preauricular area, chest, and sole of the right foot (Fig 1).
Erythematous erosions on the (A) scalp, (B) malar areas and mandible, (C) pre- and postauricular areas, and (D and E) a few on the thighs.
gr2.jpg
PMC4809475_01_gr2.jpg
fig2
Several erythematous erosions were also noted on the scalp, pre- and post-auricular areas, malar areas, mandible, and chest, with a few on the arms and thighs (Fig 2).
Subepidermal blister (asterisk) with superficial perivascular lymphohistiocytic (yellow triangle) and eosinophilic infiltrate (blue triangle). (Hematoxylin-eosin stain; original magnification: x20.)
gr3.jpg
PMC4809475_01_gr3.jpg
fig3
A 4-mm skin punch biopsy specimen from the edge of the blister on the chest was submitted for histologic examination (hematoxylin-eosin stain), which found a subepidermal blister with a superficial perivascular lymphohistiocytic and eosinophilic infiltrate (Fig 3).
IgG direct immunofluorescence of perilesional skin shows linear deposits of (A) IgG (+1) and (B) C3 (+2) in the basement membrane zone.
gr4.jpg
PMC4809475_01_gr4.jpg
fig4
Direct immunofluorescence of perilesional skin from the chest showed linear deposits of IgG (+1) and C3 (+2) in the basement membrane zone (Fig 4).