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November 1988

Arciform Blistering in an Elderly Woman

Author Affiliations

University of Iowa Hospitals and Clinics, Iowa City

Arch Dermatol. 1988;124(11):1705-1706. doi:10.1001/archderm.1988.01670110065014

REPORT OF A CASE  A 60-year-old woman with a three-month history of a mildly pruritic vesiculobullous eruption involving the extensor surfaces of the extremities, abdomen, and sacral region was referred to the Department of Dermatology at University Hospitals, University of Iowa, Iowa City. A diagnosis of bullous pemphigoid had been made by the referring physician on the basis of the initial clinical presentation and histologic findings of a subepidermal split in a lesional skin biopsy specimen. Direct immunofluorescence of perilesional skin had been performed and showed weak, focal C3 and strong continuous fibrinogen at the basement membrane. Initially, the patient showed a good response to 50 mg of prednisone orally once daily. Azathioprine (Imuran) therapy in a dosage of 50 mg twice daily orally was started four weeks before we saw her; after azathioprine therapy was started, the dosage of prednisone was gradually decreased. She did well until the daily

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