Blistering of the Hands and Forearms

REPORT OF A CASE  An 18-year-old white man previously in good health presented with a 1-day history of erythema and bullae over the dorsa of his hands. There had been four previous outbreaks of erythema with minimal vesiculation in the same location, with the first occurring approximately 4 months before presentation. Each outbreak spontaneously resolved. He took no medications and had no family history of skin disease or known allergies. He denied knowledge of any precipitating or alleviating factors. He had worked as a grocery sacker for 7 months. One fellow worker with the same duties experienced similar lesions coincident with the patient.Physical examination revealed type II skin showing three 10- to 15-mm bullous lesions with clear fluid and well-demarcated rims of erythema on the dorsum of the left hand (Figure 1 and Figure 2).There was also a linear 15-mm erythematous streak on the dorsum of the right