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April 1990

Bizarre Widespread Vesicular Eruption

Author Affiliations

USA; USA; Walter Reed Army Medical Center, Washington, DC

Arch Dermatol. 1990;126(4):529-530. doi:10.1001/archderm.1990.01670280113022

REPORT OF A CASE  A 27-year-old man presented to the dermatology clinic with a 4- to 5-week history of slightly tender, mildly pruritic groups of blisters. The lesions first appeared on the patient's scalp and subsequently spread to his face, trunk, and extremities. Some lesions had spontaneously resolved, and whitish, bizarre-shaped lesions were present in these areas.Physical examination revealed multiple grouped vesicular lesions in unusual configurations. Most vesicular lesions were circinate and iris-shaped with erythematous bases. Many lesions were serpiginously arranged and extended over several centimeters of skin. The individual vesicles were shiny, tense, and transparent, and measured approximately 2 to 4 mm in diameter. In addition, several hypopigmented patches were present. These assumed similar unusual configurations to the aforementioned vesicular lesions (Figs 1 and 2).A biopsy specimen was obtained and is shown in Figs 3 and 4.What is your diagnosis?

DIAGNOSIS:  Dermatitis herpetiformis (DH)

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