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JAMA Dermatology Clinicopathological Challenge
July 2014

Widespread Vesiculobullous Eruption in an Adolescent Girl

Author Affiliations
  • 1School of Medicine, Stony Brook University, Stony Brook, New York
  • 2New York Medical College, Valhalla, New York
JAMA Dermatol. 2014;150(7):771-772. doi:10.1001/jamadermatol.2013.9808

An adolescent girl presented with a vesiculobullous eruption that worsened over the course of 3 weeks. The patient reported a medical history significant for alopecia areata, and additional symptoms including chronic fatigue and intermittent nonswelling arthralgia.

The patient initially presented to her primary care clinician with smooth erythematous pruritic plaques on the chin and neck. Believed to be poison ivy, her erythematous eruption was treated with oral corticosteroids and diphenhydramine. The lesions generalized 2 days later to the periorbital region, nose, arms, groin, and buttocks. In addition, the lesions became vesicular in nature. A physical examination demonstrated multiple tense pruritic fluid-filled blisters (Figure, A). A 4-mm punch biopsy was performed.

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