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In children, and sometimes adults, lesions are annular / polycyclic, often with blistering around the edge known as the 'string of pearls' sign Refer to the related chapter Linear IgA disease Erythema multiforme Can become generalised - refer to the notes in the section below on hands / forearms Epidermolysis bullosa acquisita - generalised inflammatory type (figure 30) This is extremely rare Findings are similar to bullous pemphigoid Refer to the related chapter Epidermolysis bullosa acquisita Bullous systemic lupus erythematosus (figure 31) Is an immunobullous condition, usually arising in patients with well-established SLE The blistering is widespread, although in some patients the eruption is photosensitive Lesions vary in size from vesicles to large bullae Mucosal lesions are uncommon Histologically the blisters are subepidermal

This medication provides a deeper level of anesthesia and is given by an anesthesia team present during the procedure

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