Generalized pruritic eruption with suprabasal acantholysis preceeding the development of bullous pemphigoid

We report a patient who presented with a papular pruritic eruption of a 3-m onth duration that histologically showed suprabasal acantholysis accompanie d of an eosinophilic inflammatory infiltrate that was consistent with the d iagnosis of Grover's disease. Later, erythematous plaques and vesicles appe ared which showed a histopathological pattern of eosinophilic spongiosis. T he direct immunofluorescence (DIF) study showed lineal IgG and C'3 at the d ermal epidermal junction which was consistent with the diagnosis of bullous pemphigoid. No anti-intercellular deposits of immunoglobulin G (IgG) or C' 3 were observed. We consider that suprabasal acantholysis may represent the early phase of bullous pemphigoid.