Split in lamina lucida area

Abbreviation: DEJ, dermal-epidermal junction.

Abbreviation: DEJ, dermal-epidermal junction.

Classification Variants, Mutations, and Other:

■ Vancomycin the best-documented causative drug

■ Preceding infection and hematopoietic malignancy also associated with linear IgA bullous dermatosis


Bullous lupus erythematosus is characterized by widespread or localized nonscarring vesiculobullous eruption on the upper trunk, face, scalp, and/or extremities (Fig. 8A). The blistering is usually self-limiting and typically occurs in a patient with a flare of known systemic lupus erythematosus.

Histology (Figs. 8B and D):

■ Linear neutrophilic interface dermatitis

■ Sometimes papillary microabscesses of neutrophils as in dermatitis herpetiformis

■ Neutrophilic dust and extension of infiltrates into papillary dermis (not seen in dermatitis herpetiformis or in linear IgA bullous disease)

Differential Diagnosis:

■ Dermatitis herpetiformis; linear IgA bullous disease


■ DIF: always IgG, usually IgA, and sometimes IgM and C along the basement membrane zone in granular (60%), linear (40%), and sometimes mixed patterns

■ IIF: circulating antibodies not usually seen when utilizing monkey esophagus epithelium

■ IIF-SSS: immunoreactants that bind to the dermal side of the split

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