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January 1987

Vesicles on the Dorsa of the Fingers

Author Affiliations

Mercy Hospital, Springfield, Mass

Arch Dermatol. 1987;123(1):109-110. doi:10.1001/archderm.1987.01660250115033

REPORT OF A CASE  A 32-year-old male machine operator was initially seen for evaluation of blisters on his hands and forearms of six weeks' duration. His wife stated that he drank alcoholic beverages moderately at least three days a week but did not miss any work. Laboratory data included the following: serum bilirubin, 0.4 mg/dL (7 μmol/L); serum alkaline phosphatase, 88 U/L; aspartate aminotransferase, 106 U/L; alanine aminotransferase, 212 U/L; and fasting blood glucose level, 223 mg/dL (12.4 mmol/L). A biopsy was performed on one blister. He was seen five years later for small blisters involving the dorsal aspect of his hands that were associated with a burning sensation. The lesions had no relation to sun exposure. The patient was taking no medications. Physical examination revealed facial melanosis (Fig 1) and several 2- to 3-mm flaccid vesicles on the dorsa of his hands, some of which were associated with postinflammatory

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