(BMJ) - A 13-mo-old boy presents with multiple pruritic tense blisters for 1 wk. No family Hx of skin disease, no recent URI, no medications. Exam: Lesions have a “cluster of jewels” appearance; no mucosal lesions. What is the diagnosis?
Herpes zoster
Linear immunoglobulin A (IgA) dermatosis
Porphyria cutanea tarda
Thermal burn
Toxic epidermal necrolysis
You are correct. Linear immunoglobulin A (IgA) dermatosis is an autoimmune subepidermal vesiculobullous disease of children (chronic bullous dermatosis of childhood) and adults. Vesicles and bullae are usually arranged in an annular manner described as the “cluster of jewels” appearance. Remission occurs in 64% of children within 2 to 4 years. Most cases respond to dapsone or sulfapyridine. Additional therapy with systemic corticosteroids may be needed. Erythromycin may be a helpful adjunct with other systemic agents.