Case for diagnosis
A 27-year-old woman at 28-weeks gestation presented with a widespread, pruritic eruption\nof macular, confluent lesions with tense vesicles and some blisters in the arms and\nthighs (). The lesions initially presented\nat 26 weeks of gestation on the legs and spread to the abdomen, arms, and back. Past\nmedical history included one prior abortion due to sicklecell disease, without any\nhistory of similar symptoms. The patient had been previously treated with\nmethylprednisolone cream and oral cetirizine, with persistence of the skin lesions. A\ncutaneous biopsy was performed in lesional skin, showing the presence of multiple\nvesicles in the dermal-epidermal junction, filled by serosity and eosinophils. In the\nunderlying dermis, a marked edema outlined a dermal-epidermal detachment, with a dense\ninflammatory infiltrate (predominantly with eosinophils) extending to the dermis (). Direct immunofluorescence in perilesional\nnoninvolved skin showed linear deposists of C3 at the basement-membrane zone ().