Case Number : Case 2085 - 4 June 2018 Posted By: Limin Yu

Chronic heliodermatitis. The subepidermal cleft is probably artifactual. Eosinophils may be there because of mild contact sensitisation due to topically applied cream or some component of sunscreen.

My first spot is Dermatomyositis. 

Too eosinophils indeed. Many doubt about my first spot of DM ( based upon dermal mucin and interface mild changes ). Could be a consequence of topical creams, as suggested by Anil, on a DM lesion? Or  cancer-therapy-induced DM-like reaction? Single lesion or eruption? Itching?

I apologize that the pictures are not representative. This is a subepidermal bullous dermatitis with eosinophils. DIF shows linear deposition of antibodies against IgG and C3 at DEJ. The findings are compatible with BP. 

Unfortunately I can't post DIF pictures due to the  limit of file size of attachment (0.11MB, which is too low for pathology pictures).