The biopsy specimen revealed an upper dermal chronic inflammatory cell infiltrate. There were fibrin deposits in the dermal papillae, with no evidence of microabscess formation. There was an intraepidermal bulla, with vesiculation and some spongiosis. The epidermis below this was rather thick. There was some central dermoepidermal splitting. Immunofluorescence revealed a linear band of IgA deposited at the dermoepidermal junction in perilesional skin.
Oral sulfapyridine therapy (1g/d) was initiated. Within 3 days, severe nausea developed and the sulfapyridine therapy was discontinued. Oral dapsone therapy (50 mg twice daily) was then started. Within 1 week, the patient's blisters were beginning to disappear, with no new lesions developing. He was discharged home, and at review after 6 weeks, there were a few new blisters present.
Multiple Blisters in a Young Boy. Arch Dermatol. 1998;134(5):625-630. doi: