Bullous systemic lupus erythematosus (BSLE) and epidermolysis bullosa acquisita (EBA) are subepidermal blistering diseases associated with autoimmunity against type VII collagen.1 The criteria for the diagnosis of BSLE include (1) a diagnosis of systemic lupus erythematosus (SLE), (2) a nonscarring vesiculobullous eruption, (3) subepidermal blisters with a neutrophil-rich infiltrate in the papillary dermis, (4) deposition of immunoreactants at the epidermal basement membrane, and (5) immunoglobulin deposits at or beneath the lamina densa seen by immunoelectron microscopy.2