case_images: PMC11763885_01
case_images: Palpable purpura with bullae on left lower extremity.
case_images: gr1.jpg
case_images: PMC11763885_01_gr1.jpg
case_images: fig1
case_images: On examination, the patient had deeply purpuric macules to papules that were coalescing with scattered bullae on the bilateral lower extremities, lower back, and abdomen (Fig 1).
case_images: Low-power view of fibrinoid necrosis, stained with H&E. Magnification: x40.
case_images: gr2.jpg
case_images: PMC11763885_01_gr2.jpg
case_images: fig2
case_images: Punch biopsies were performed on the right abdomen, and histopathology showed a subepidermal vesicle filled with neutrophils, consistent with LABD (Figs 2 and 3).
case_images: H&E stain of a subepidermal vesicle with neutrophils and fibrinoid necrosis of vessel walls with fragments of neutrophils. Magnification: x200.
case_images: gr3.jpg
case_images: PMC11763885_01_gr3.jpg
case_images: fig3
case_images: Punch biopsies were performed on the right abdomen, and histopathology showed a subepidermal vesicle filled with neutrophils, consistent with LABD (Figs 2 and 3). However, it also showed a superficial perivascular neutrophilic infiltrate with occasional eosinophils in addition to fibrinoid necrosis of superficial vessels (Fig 3).
case_images: Direct immunofluorescence of thick linear IgA deposition along the cutaneous basement membrane zone.
case_images: gr4.jpg
case_images: PMC11763885_01_gr4.jpg
case_images: fig4
case_images: The direct immunofluorescence (DIF) showed a thick linear IgA deposition along the epidermal basement membrane zone (Fig 4).