Interactive Case Study - October 2018

Question 1:

A 44-year-old African American female presented to the office with approximately 2 months of multiple blisters, involving her abdomen, left ventral wrist, upper thighs and dorsal hands. The blisters were occasionally pruritic and had erupted within a few days of each other. Two punch biopsies of lesions on the right upper thigh were performed. Histopathology of lesional skin (Figures 1-3), and perilesional skin for DIF (Figure 4) reveal:

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Figure 1. 50x

 
Figure 2. 200x

 
Figure 3. 200x

 
Figure 4. DIF of IgA, 100x

Which of the following is the best diagnosis?
 

A.  Dermatitis herpetiformis

B.  Bullous pemphigoid

C.  Linear IgA bullous dermatosis

D.  Bullous systemic lupus erythematosus

E.  Epidermolysis bullosa acquisita