At that time we noticed many tense blisters, in configurations somewhat resembling Chinese Symbols, which appeared over healthy skin or over urticarial plaques. Gradually, predilected to the upper back, buttocks, hands, elbows, feet and knees, a cigarette paper-like atrophic scars, miliae and loss of finger and toe nails appeared. Ever since the initial episode there are flares with short periods of spontaneous remissions, with a constant worsening. Wide erosions develop and heal with the formation of atrophic scars, milia, loss of nails and webbing of adjacent finger. Skin of involved areas becomes atrophic with a quality of cigarette paper.
Physical examination is unremarkable otherwise.
Mixed inflammatory infiltrate, containing a few eosinophiles and intercellular edema in the upper dermis. There was a burst of urticarial plaques and angioedema of palms and soles. The eruption was attributed to disease, but three months later on rechallenge the same lesions appeared and it was obviously drug eruption due to Prednisone. Dapsone administration resulted in hemolysis. Colchicine 0.5mgx2 was not effective.