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Jennifer Chwalek, MD; Jennifer Cooper, MD; Ronald Goldner, MD; Grace Kao, MD
University of Maryland (Drs Chwalek, Cooper, and Goldner) and Veterans Affairs Maryland Healthcare System (Dr Kao), Baltimore

Arch Dermatol. 2008;144(5):673-678.

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

REPORT OF A CASE

A 2-year-old boy was admitted with an acute onset of generalized bullae. Before hospitalization, he had developed generalized erythema, become lethargic, and had an episode of vomiting and diarrhea. Within 2 hours, tense bullae had appeared, mostly on his head, neck, arms, and trunk. His only medication at the time of admission was dextromethorphan, for an upper respiratory tract infection. The findings of his medical history were unremarkable, except for occasional urticaria, which worsened with heat exposure.

Physical examination revealed clusters of tense hemorrhagic bullae on the scalp, forehead, chest, back, umbilicus, and perineum (Figure 1). A punch biopsy specimen from one of the bullae was sent for histologic examination (Figure 2 and Figure 3), and a punch biopsy specimen of perilesional skin was sent for direct immunofluorescence.

Figure appears in full text version. Figure 1.

Figure appears in full text version. Figure 2.

Figure appears in full text version. Figure 3.

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Arch Dermatol. 2008;144(5):673-678.
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