Abstract

A man in his 50s with a 3-year history of Crohn disease presented with a 1-week history of pruritic blistering on the trunk and extremities. Examination revealed tense vesicles arranged in annular pattern on the nape, upper back, and extensor side of the upper arms (Figure 1). No new medications were initiated in the past 3 months, including antibiotics, angiotensin-converting enzyme (ACE) inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). A skin biopsy from the right upper arm showed a subepidermal blister with neutrophilic infiltrates at the basement membrane and papillary dermis.

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