Intraepidermal neutrophilic IgA dermatosis

We report a patient with a vesiculopustular eruption with features distinct from typical subcorneal pustular dermatosis. Clinically, well-formed pustular lesions, which were flowerlike in appearance, were present. Histopathologically, early vesicular lesions showed intraepidermal bullae containing numerous neutrophils, a few eosinophils, and acantholytic cells. Direct immunofluorescence study revealed IgA deposits in the intercellular space of the epidermis. The patient's serum, however, did not contain circulating antibodies reactive with the epidermis. We consider this eruption an immunologically mediated, intraepidermal blistering disease, similar to intraepidermal neutrophilic IgA dermatosis.