History:

This elderly lady had been diagnosed with bullous pemphigoid and treated with high dose steroids for many years without good control.Biopsy and immunofluorescence showed IgA in a linear pattern on the basement membrane not the IgG and C3 you would see in bullous pemphigoid.She responded to low dose Dapsone and Colchicine.Her case is discussed in more detail in www.dermconsult.com.au

Note that linear IgA disease in adults is commonly seen as a drug reaction particularly to Vancomycin and Captopril.