A 63-year-old woman presented with a 4-year history of a persistent, pruritic vesicular skin eruption. Her medical history was notable for psoriatic arthritis. There was no family history of autoimmune disease or immunobullous disorders. Examination revealed scattered annular and arcuate erythematous plaques with raised, slightly edematous borders studded with erosions and occasional vesicles. These lesions were located on her trunk, arms, and legs with relative sparing of her face and complete absence of mucous membrane involvement (Figure 1). Two biopsies were taken, one for routine hematoxylin-eosin staining (Figure 2) and the other for direct immunofluorescence (Figure 3).
Kleker BM, Ramirez-Fort MK, Puchalsky D, Longley BJ, Swanson A, Zone J. A Generalized Annular Eruption With Occasional Vesicles—Quiz Case. Arch Dermatol. 2012;148(4):531–536. doi:10.1001/archdermatol.2012.1a
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