Abstract
An 84-year-old woman with a 40 year history of gait disturbance due to rheum atismbecame bedridden from 1 year ago. 2 months prior to her visit to on clinic ulcers have developed on the sacral region, both thighs, and both heels, and increased in size. The margins of the ulcers on both heels wereelevated, and the surrounding area was hardand papillomatous. Histology of the left heelshowed epidermal thickening, pseudoepitheliomatous hyperplasia, and papillomatosis. Fromabout 8 weeks after the first consultation, blisters began to appear and disappear on both shins and the dorsal regions of both feet, whose histological feature showed to be subepidermal blisters, surrounded by dense eosinophilic infiltration. Direct immunofluorescence showed negative IgG and C3 deposit on BMZ.
