Vancomycin‐induced linear IgA bullous dermatosis (LABD)—an atypical presentation

Abstract

Key clinical message We report an uncommon presentation of bullous dermatosis by linear IgA. There are few cases reported in the literature with this form of presentation starting with mucosal lesions and then evolving into a similar bullous pemphigoid pattern. In addition, we emphasize the importance of direct immunofluorescence for the definitive diagnosis.

Purpuric Bullae on the Lower Extremities

“…Linear IgA bullous dermatosis represents a rare subepidermal vesiculobullous disease occurring in patients in their 60s. 7 Clinically, this entity presents as tense bullae often located on the periphery of an urticarial plaque, classically called the "string of pearls sign." Histologically, LABD also presents with subepidermal split; however, neutrophils are the predominant cell type vs eosinophils in BP (Figure 2).…”

“…Histologically, LABD also presents with subepidermal split; however, neutrophils are the predominant cell type vs eosinophils in BP (Figure 2). 7 Direct immunofluorescence is specific with a linear deposition of IgA at the dermoepidermal junction.…”