case_images: PMC11812991_01
case_images: Patients before treatment (neck, chest, forearms, and lower limbs).
case_images: medi-104-e41448-g001.jpg
case_images: PMC11812991_01_medi-104-e41448-g001.jpg
case_images: F1
case_images: Physical examination showed the following: the skin on the face, neck, chest, forearms, and lower limbs shows patchy areas of thickened erythematous papules, plaques, and blisters (Fig. 1).
case_images: Histopathology showing mild epidermal hyperplasia with focal spongiotic edema (H&E stain,  40). Necrosis of keratinocytes in the upper layers of the basal layer, with mild perivascular infiltration of lymphocytes, histiocytes, and eosinophils in the superficial dermis, along with extravasation of red blood cells (H&E stain,  200).
case_images: medi-104-e41448-g002.jpg
case_images: PMC11812991_01_medi-104-e41448-g002.jpg
case_images: F2
case_images: Pathological examination of the lower limb skin lesion is revealed (Fig. 2).
case_images: Histopathology showing subepidermal blister (H&E stain,  40). Superficial dermis infiltration of lymphocytes, some neutrophils, and few eosinophils (H&E stain,  200).
case_images: medi-104-e41448-g003.jpg
case_images: PMC11812991_01_medi-104-e41448-g003.jpg
case_images: F3
case_images: Four days after the patient was hospitalized, scattered bullae appeared at the site of the primary rash, and pathological examination of the chest skin lesion is revealed (Fig. 3).
case_images: Direct immunofluorescence showed linear IgG and C3 along the basement membrane zone ( 100).
case_images: medi-104-e41448-g004.jpg
case_images: PMC11812991_01_medi-104-e41448-g004.jpg
case_images: F4
case_images: Direct immunofluorescence is shown (Fig. 4).