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Arch Dermatol. 2005;141:1161-1166.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Diagnosis: Urticarial bullous pemphigoid (BP).

MICROSCOPIC FINDINGS AND CLINICAL COURSE

An initial biopsy specimen from the right areola showed spongiotic psoriasiform dermatitis with a superficial infiltrate of eosinophils and lymphocytes. Eosinophils were noted at the dermoepidermal junction. A second biopsy specimen from the edge of a plaque on the right breast was similar. Direct immunofluorescence showed linear deposition of C3 and IgG at the dermoepidermal junction. Indirect immunofluorescence on salt-split skin showed immunoreactants on the roof of the salt-induced blister.

A diagnosis of the urticarial variant of BP was made, and treatment with topical clobetasol propionate applied daily and oral tetracycline hydrochloride (500 mg 3 times a day) was initiated. The patient had previously experienced an adverse reaction to niacin, so niacinamide was not administered along with the tetracycline. There was significant improvement in the patient’s condition, and topical desonide was applied twice a day Monday through Friday, with continuation of treatment with the clobetasol on the weekends.

DISCUSSION

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Arch Dermatol. 2005;141(9):1161-1166.
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