PMC3556408_01
Multiple-grouped flaccid pustules varying in size from 2 to 10 mm that tended to coalesce to form annular, circinate, or serpiginous pattern and superficial crusts on the normal or mildly erythematous skin, of the face, trunk, and extremities.
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The dermatologic examination revealed multiple-grouped flaccid pustules varying in size from 2 to 10 mm that tended to coalesce to form annular, circinate, or serpiginous pattern and superficial crusts on the normal or mildly erythematous skin, of the face, trunk, and extremities (Figure 1).
Histological examination: subcorneal pustule immediately below the stratum corneum containing mainly neutrophils; the underlying epidermis show slight intercellular edema (HE x20).
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Histopathology demonstrated a subcorneal vesiculo-bullous dermatitis (Figure 2); the pustule is located immediately below the stratum corneum and contains mainly neutrophils with few eosinophils.
Immunofluorescence. IgA-FITC 40X. The figure shows no antibody reactivity in epithelial cells and dermal-epithelial junction (basement membrane).
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Direct immunofluorescence studies are negative for immunoglobulin A (IgA) intercellular accumulation (Figure 3).
Followup at 2 weeks. The patient was treated with Dapsone. The cutaneous lesions were almost completely healed.
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The cutaneous lesions were almost completely healed at the first followup, within 2 weeks (Figure 4).