Linear IgA Bullous Dermatosis
A 5-year-old boy presented to the dermatology clinic with a 2-week history of painless blisters localized to the scrotum (Panel A). He was otherwise healthy and not using any medications. Physical examination showed multiple painless and tense bullae containing clear to slightly hemorrhagic fluid on the scrotum. There were no mucosal abnormalities or blisters seen elsewhere. A biopsy specimen of one of the lesions was obtained, and histopathological testing revealed subepidermal blisters that contained eosinophilic and neutrophilic infiltrates. Direct immunofluorescence antibody staining of a perilesional area showed a linear band of IgA deposition along the dermoepidermal junction (Panel B), a finding that confirmed the diagnosis of linear IgA bullous dermatosis. This autoimmune blistering disease can occur in children and adults; the perioral and perineal areas may be more commonly affected in children than in adults. With high-potency topical glucocorticoid treatment, the patient’s lesions healed within 2 weeks, with no recurrence.
