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April 1997

Diffuse Blisters and Erosions in a Patient With Limited Scleroderma

Author Affiliations

USA; USA; Fitzsimons Army Medical Center, Aurora, Colo

Arch Dermatol. 1997;133(4):504. doi:10.1001/archderm.1997.03890400105016

REPORT OF A CASE  A 65-year-old white woman with a 2-year history of limited scleroderma with interstitial lung disease was sent by the rheumatology clinic for the evaluation of increasing numbers of pruritic blistering lesions that had been forming on her face, neck, and trunk for 3 weeks. These lesions ruptured within hours after formation. The patient was taking multiple medications for the treatment of her limited scleroderma (CREST syndrome), interstitial lung disease, keratoconjunctivitis sicca, and hypertension.On physical examination, the patient demonstrated multiple 3- to 10-mm scaling and erythematous erosions on her forehead (Figure 1), chest (Figure 2), neck, and upper back area. Her mucous membranes were free of lesions. Scattered telangiectases and distal phalangeal sclerodactyly were noted on both hands. The patient had a positive Nikolsky sign on clinically uninvolved skin of the presternal region.Histopathologic sections of a scaly, erythematous erosion from the neck are shown in

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