Bullous Dermatosis vs Amyloidosis

To the Editors.—  I would like to speculate on the pathologic condition of the patient described by Vincendeau et al in the June Archives (1980;116:681-682) as having a bullous dermatosis, without determining the "exact ultrastructural localization of blistering." At the right side of Fig 2 in their article, the bulla seems to form intradermally below a normal epidermis and a normal basement membrane zone. Since myeloma is often associated with amyloidosis, stains for amyloid might have shown that the bulla is formed by cleavage through fragile dermal amyloid deposits.¹ The immunofluorescence microscopy findings would probably be unrelated to or secondary to bulla formation.