Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious inflammatory response associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Mucocutaneous findings are often present but remain poorly defined overall, and more precise dermatologic descriptions are not only necessary to better characterize this syndrome, but may also aid in early diagnosis and prevention of severe deterioration or death. We report the case of a 16-month-old boy presenting with a diffuse maculopapular eruption, cheilitis, and vesiculobullous lesions of the scrotum, perianal region, and distal lower extremities. Tense bullae of the genitals and lower extremities have not been previously reported in MIS-C and add to the spectrum of skin findings associated with the disorder.
We present a rare case of linear IgA bullous dermatosis (LABD) in a 72-year-old male associated with the use of azithromycin. LABD presents as subepidermal blisters due to IgA antibodies targeting BPAG2, a component of hemidesmosomes. LABD is a rare diagnosis and may be idiopathic, associated with illness, or medication-induced. The patient experienced a rash five days after completing a course of azithromycin for pneumonia. The diagnosis of LABD was confirmed with a biopsy and direct immunofluorescence. Lesions resolved over two weeks with an oral prednisone taper and topical clobetasol. This case represents just one of two previously reported cases in the literature of azithromycin-associated LABD. While LABD is well known to be induced by certain medications, this is only the second report of it being associated with the use of a macrolide. We propose that macrolides be included as a potential cause of medication-induced LABD.
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