Abstract
A 55-year-old Chinese man presented with acute onset of a vesicobullous rash on his face, axillae, genitalia and trunk. The skin biopsy showed a subepidermal bulla. The diagnosis was made by direct immunofluorescence of the perilesional skin which revealed characteristic linear deposition of IgA along the dermoepidermal junction. He was successfully treated with dapsone initially but subsequently developed erythema multiforme, possibly due to dapsone. Linear IgA dermatosis should be considered in patients presenting with bullous lesions, even when the distribution of the rash is atypical. Alternative diagnoses should be entertained when patients experience an unexpected relapse whilst on treatment. We highlight the important points in the clinical presentation, diagnosis and the problems encountered in the treatment of this uncommon skin disorder.
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