Thursday, February 10, 2011

Taurus

This rash is seen on the back of the neck of an eighty year old woman who has HTN, DM, dyslipidemia, COPD, arthritis, urinary incontinence, GERD, and migraines. Her medication list spans two pages. Lesions are noted in flexural areas, the groin, the axillae, and the mouth. They are itchy. A diagnostic procedure is done and results are shown below:

Challenge: What's your most likely diagnosis?

Both images shown under Fair Use.

3 comments:

  1. Bullous pemphigoid - IgG against hemidesmosomes.

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  2. exactly right!
    -
    Taurus

    This is bullous pemphigoid. The second image shows immunofluorescence for autoantibodies to epidermal basement membrane, leading to subepidermal blisters.

    Sources: UpToDate; healthcare.uiowa.edu; missinglink.ucsf.edu.

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