Linear IgA bullous dermatosis (LABD) in adults most characteristically shows which clinical distribution pattern that distinguishes it from bullous pemphigoid?

• A Tense blisters on urticarial plaques on trunk
• B Flaccid blisters with Nikolsky sign on face
• C Symmetric pruritic vesicles on extensor surfaces
• D Perioral and genital annular blisters ('cluster of jewels' sign) ✓

Explanation

LABD classically presents with annular and polycyclic blisters arranged in a 'cluster of jewels' or 'string of pearls' pattern, often perioral and perineal. DIF shows linear IgA at BMZ targeting BP180 LAD-1 97 kD fragment. Unlike BP (IgG, eosinophil-rich subepidermal bulla), LABD shows neutrophil-rich subepidermal bulla. It may be drug-induced (vancomycin is the most common trigger).

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.