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JAMA Dermatology Clinicopathological Challenge |

Blistering Eruption of the Buttocks QUIZ

Yuxin Evelyn Tay, MBBS, MRCP1; Inny Busmanis, MBBS, FRCPA, FAMS2; Haur Yueh Lee, MRCP3
[+] Author Affiliations
1National Skin Centre, Singapore
2Department of Pathology, Singapore General Hospital, Singapore
3Department of Dermatology, Singapore General Hospital, Singapore
JAMA Dermatol. 2015;151(12):1367-1368. doi:10.1001/jamadermatol.2015.2876.
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An elderly woman with progressive, painful blisters, ulcers of the groin, and enlargement of the tongue was found to have circinate purpuric patches with erosions on the natal cleft and buttocks. What is the diagnosis?

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A, Purpura and erosions at the buttocks. B, Clinical findings of macroglossia and glossitis with purpura of the lips. C, Punch biopsy specimen of a flaccid bulla showing the floor of a subepidermal blister lined by fibrin and a chronic inflammatory infiltrate. D, Scattered short eosinophilic amorphous bands in the dermis.

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