The patient was a 58-year-old woman who had multiple pruritic vesicles on the trunk, buttocks, thighs, tongue and buccal mucosa.

A biopsy of a lesion revealed subepidermal vesicles. Direct immunofluorescence examination of the perilesional skin showed a linear deposition of IgA along the basement membrane zone (BMZ). Indirect immunofluorescence examination, using NaCl split skin as substrate, showed antiBMZ IgA antibodies bound only to the epidermal side.

The skin lesions responded well to oral dapsone therapy.