Adult-Onset Linear IgA Bullous Dermatosis with Secondary Infection: A Comprehensive Therapeutic Approach

Abstract

Linear IgA bullous dermatosis (LABD), a rare autoimmune blistering disorder, causes the accumulation of immunoglobulin A (IgA) throughout the basement membrane zone. Because it can affect both adults and children and sometimes mimics other vesiculobullous disorders, diagnosing the ailment can be difficult. We describe a 42-year-old woman who, for the previous four months, had been suffering from severely itchy vesiculobullous eruptions over her limbs and trunk. A clinical examination revealed tense vesicles and bullae arranged in circular patterns that mimicked the classic "string of pearls" appearance, along with little mucosal involvement. Direct immunofluorescence revealed a subepidermal blister with inflammatory cell infiltration and linear IgA deposition at the dermo epidermal interface, confirming the diagnosis of linear IgA bullous dermatosis. Laboratory tests also revealed evidence of secondary bacterial infection. The patient underwent topical medicine, corticosteroids, targeted antibiotics, and systemic dapsone treatment once glucose-6-phosphate dehydrogenase deficiency was ruled out. There was a discernible clinical improvement within two weeks, including a reduction in pruritus and a halt to the formation of new blisters. For the successful treatment of this rare autoimmune blistering illness, this example highlights the importance of early therapeutic intervention and clinicopathological linkage.