Case Number : Case 1484- 02 March Posted By: Guest

Probably Adult linear IgA bullous dermatosis (if the immunofluorescence is for IgA demonstration). Maybe the patient received Vancomycin...

Agree. The differentials on the H&E are those of a sub-epidermal blistering disorder with neutrophils. Would add bullous SLE to the differential. Not sure what the linear deposition is on the direct IMF.

Pemphigoid and epidermolysis bullosa acquisita can both be neutrophil-rich (if the IMF is IgG or C3). 

Agree.

Agree with Abdul! And (if the IMF is IgG or C3), in img5 top, the deposit seems on the dermis side. Probably EBA...But it need know what is the ab ( IgA or IgG or C3?)

yes, we do do need to know the IMF...probably linear IgA.

I meant, agree with adult linear IgA bullous dermatosis.

Should we also consider anti-P200 pemphigoid? Rare, linear IgG & C3 along the dermal side and histologically has neutrophils.  Clinically looks like bullous pemphigoid.

Yes, the suggestion of Dr Carr is the more consistent with clinical and pathology of this case...unfortunately don't know this new pathological chapter...so i will study it

The IF is IgA.  IgG and C3 were negative.  So I called it Linear IgA bullous dermatosis.