A 36-year-old woman presented with a 5-month history of recurrent blisters on the dorsal aspect of both hands. The blisters were initially confined to her hands, but recently she had developed facial lesions. Her medical history was remarkable for psoriasis, irritable bowel disease, and chronic lower back pain. At the time of this clinic visit, she was being evaluated for a possible autoimmune disease by a rheumatologist, and her antinuclear antibody titers were negative. Her medications included fluoxetine hydrochloride, desipramine hydrochloride, gabapentin, tizanidine hydrochloride, cromolyn sodium inhaler, and naproxen sodium. She was also using a home UV-A phototherapy unit for her psoriasis. There was no family history of skin disease.
McNail S, Parker SRS. Recurrent Blisters on the Hands and Face. Arch Dermatol. 2002;138(12):1607. doi:10.1001/archderm.138.12.1607