Linear IgA bullous dermatosis occurs in two different clinical situations. What are they?
| | Fig. 10.5 Linear IgA bullous dermatosis. Tense, circular, sausage-shaped bullae in a child. | One occurs in early childhood and has been termed chronic bullous disease of childhood. Pruritic, urticarial blisters, often sausage-shaped or like a string of pearls, develop on the buttocks and perineal areas, as well as the trunk and extremities (Fig. 10-5). Mucosal lesions are common. The adult form often occurs in the elderly and may be associated with drugs such as vancomycin. Skin lesions may resemble bullous pemphigoid or dermatitis herpetiformis. Diagnosis is by routine histologic exam of an early blister, direct immunofluorescence of perilesional skin, or indirect immunofluorescence to detect IgA antibodies directed against the basement membrane zone of skin.
Dellavalle RP, Burch JM, Tayal S, et al: Vancomycin-associated linear IgA bullous dermatosis mimicking toxic epidermal necrolysis, J Am Acad Dermatol 48:S56–S57, 2003.
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