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Vol. 107. Issue 4.
Pages 343 (May 2016)
Images in Dermatology
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Linear Immunoglobulin A Dermatosis of Childhood With the String of Beads Sign
Dermatosis ampollosa IgA lineal de la infancia y «el collar de perlas»
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F. Peral Rubio
Unidad de Dermatología, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
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Linear immunoglobulin (Ig) A bullous dermatosis of childhood, also known as chronic bullous disease of childhood, is a rare disease with highly characteristics skin lesions consisting of urticarial papules, vesicles, and tense blisters that usually arise in the perioral and genital regions and on the lower limbs. The lesions are sometimes circular or oval, showing a typical string of beads pattern at the periphery of emerging lesions. The image shown is from a 2-year-old girl who presented a 72-hour history of bullous lesions. The lesions mainly affected the limbs and genital region, with no mucosal involvement. Examination revealed tense vesicles and blisters containing a clear fluid, in an annular distribution with centrifugal growth, and there was the characteristic string of beads appearance, with concentric rings of vesicles, as may be observed in the photograph. Although diagnostic confirmation requires direct immunofluorescence that shows linear IgA deposits on the basement membrane and the presence of antibodies to the 97kD or 120kD fragments of bullous pemphigoid antigen 2 (BP180), this clinical image may be considered practically pathognomic (Fig. 1).

Figure 1
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Please cite this article as: Peral Rubio F. Dermatosis ampollosa IgA lineal de la infancia y «el collar de perlas». Actas Dermosifiliogr. 2016;107:344.

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