PMC5726672_01
Scattered tense vesicles/bullae on the nasal and labial mucosa
abd-92-05-s1-0037-g01.jpg
PMC5726672_01_abd-92-05-s1-0037-g01.jpg
f1
She developed tense, isolated and grouped vesiculobullous lesions on the face, neck, axillae, upper limbs, inguinal region, buttocks and oral, nasal and genital mucosa, over 1 week (Figures 1 to 3). She also had occasional fever and hepatomegaly.
Involvement of the left inguinal region and vaginal introitus
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PMC5726672_01_abd-92-05-s1-0037-g03.jpg
f3
She developed tense, isolated and grouped vesiculobullous lesions on the face, neck, axillae, upper limbs, inguinal region, buttocks and oral, nasal and genital mucosa, over 1 week (Figures 1 to 3). She also had occasional fever and hepatomegaly.
Subepidermal blister filled with fibrin, lymphomononuclear and
neutrophils. Basement membrane thickening (Hematoxylin & eosin,
X100)
abd-92-05-s1-0037-g04.jpg
PMC5726672_01_abd-92-05-s1-0037-g04.jpg
f4
She developed tense, isolated and grouped vesiculobullous lesions on the face, neck, axillae, upper limbs, inguinal region, buttocks and oral, nasal and genital mucosa, over 1 week (Figures 1 to 3). She also had occasional fever and hepatomegaly.
Direct immunofluorescence with linear deposits of C3 in the BMZ
abd-92-05-s1-0037-g05.jpg
PMC5726672_01_abd-92-05-s1-0037-g05.jpg
f5
Histology from skin biopsy revealed subepidermal blister filled with fibrin, lymphomononuclear cells and neutrophils, thickening of the basement membrane in the dermal papillae and mild perivascular lymphoplasmacytic infiltrate in the papillary, superficial dermis (Figure 4).
Direct immunofluorescence with fluorescence of the keratinocyte
nuclei
abd-92-05-s1-0037-g06.jpg
PMC5726672_01_abd-92-05-s1-0037-g06.jpg
f6
Direct immunofluorescence (DIF) showed deposition of linear IgG, IgA and C3 in the basement membrane zone and granular IgM (Figure 5).
Tense bullae overlying an erythematous base on the right axilla
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PMC5726672_01_abd-92-05-s1-0037-g02.jpg
f2
IgG in the dermis and epidermis and for IgA in the epidermis. Indirect immunofluorescence was negative for IgA, IgM and IgG, but the nuclei of keratinocytes fluoresced (Figure 6).