A 15-year-old white boy had been experiencing itchy papules and blisters on sun-exposed areas since he was 18 months old, primarily during the spring and summer. Sometimes, the red papules evolved into painful blisters that oozed clear fluid, became crusted, and healed with scars. Frequently, the lesions also became infected. The patient's mother observed that the eruptions flared several days after sun exposure, but also reported that multiple sunblocks were of no benefit. Over the last 5 years, the frequency of these blistering episodes markedly decreased. The patient's medical history was significant for a bout of iritis with keratitis, occasional oral blisters, and episodes of gastritis. He had no atopic diathesis, and his family history was unremarkable.
Taylor CR, Duke D. Blistering, Scarring, and Photosensitivity in a Male Teenager—Quiz Case. Arch Dermatol. 1999;135(10):1267-1272. doi:10.1001/archderm.135.10.1267