The biopsy demonstrated full-thickness necrosis of the epidermis, which was replaced by a dense neutrophilic infiltrate. Direct immunofluorescence showed linear deposition of IgA at the dermoepidermal junction. Immunostains were negative for IgG.
Vancomycin therapy was discontinued, and the blisters resolved within 2 weeks.
Linear IgA bullous dermatosis is an autoimmune bullous disorder defined by linear deposition of IgA along the basement membrane zone. Most commonly idiopathic, LABD can also occur in association with drug therapy. Vancomycin is the medication that is most often implicated. Other drugs that are associated with LABD include cefamandole, captopril, lithium, phenytoin, amiodarone, somatostatin, furosemide, diclophenac, oxaprozin, and piroxicam.1- 4
Intertriginous Bullae in a 53-Year-Old Man. Arch Dermatol. 2001;137(6):815-820. doi: