Linear
immunoglobulin A bullous
dermatosis is a rare autoimmune mucocutaneous disorder caused by
immunoglobulin A autoantibodies produced against several different
antigens in the basement membrane zone. Clinically, it is characterized by tense vesicles or
bullae, which on histopathological exam demonstrate subepidermal
blister with a predominantly neutrophilic infiltrate. A smooth, linear pattern of
immunoglobulin A deposition in the basement membrane zone on direct immunofluorescence is considered the gold standard for establishing a diagnosis. Treatment consists of
dapsone or
sulfapyridine. The authors report a 60-year-old woman who presented with pruritic erythematous patches and plaques on her trunk, back, and legs without
blisters, who was diagnosed with
eczema for several months with no response to prior treatments. A biopsy was performed, which was consistent with linear
immunoglobulin A bullous
dermatosis and later confirmed by direct immunofluorescence studies. The authors present this case to increase awareness of this
rare disease, which could manifest in a nonclassical, nonblistering fashion.