Disease Clinical Features Histology Direct Immunofluorescence (perilesional skin) Indirect
Immunofluorescence
Antigen
Chronic Bullous Disease of Childhood
(CBDC)
“cluster of jewels” pattern, vesicles or bullae on perigenital area, extremities, trunk, face Subepidermal cavity  with
neutrophils along the basement membrane
vacuolar degeneration,
eosinophils
may be present
linear deposition of IgA along the basement membrane, rare associated deposits of IgG, IgM, and C3 negative in the majority of cases 97-kDa,
120-kDa
antigen
Bullous Pemphigoid tense vesicles or bullae on erythematous base on the inner surface of the thighs, forearms, axillary folds,
palms, soles
subepidermal cavity  with an
inflammatory infiltrate, predominantly of
eosinophils
linear deposition  of  C3 and IgG along the basement membrane linear deposition  of  C3 and IgG along the basement membrane 230-kDa, 180-kDa
Dermatitis Herpetiformis pruritic papules and vesicles on the extensor surfaces of the limbs,
buttocks, shoulders, nape of
neck, scalps
subepidermal cavity with
neutrophils in the dermal
papillae,
edema of the papillary dermis, eosinophils may be
present
granular deposition of IgA in dermal papillae negative epidermal transglutaminase
Erythema multiforme Papules, vesicles, targetoid lesions on palms, soles, extremities, trunk, oral mucosa subepidermal blister with infiltrate of lymphocytes in the underlying dermis, a few eosinophils, the epidermis overlying the blister may show necrosis, apoptotic keratinocytes present in the epidermis adjacent to the blister negative negative -
Table 1: Differential Diagnosis of CBDC.