A previously healthy 2-year-old boy was brought to clinic with a 1-week history of itchy, red spots. Three days before the onset of the rash, the child had had an upper respiratory infection for which he had been given ibuprofen. On physical examination, tense vesicles and edematous pink plaques with central erosions and crust were seen on the patient’s legs, arms, and back. Dense clustering of skin lesions was observed in the axillae and inguinal folds. No mucosal involvement was noted. Histopathological analysis of a skin-biopsy sample obtained from the right lower back showed a subepidermal blister with robust neutrophilic infiltration. Direct immunofluorescence revealed a linear band of IgA along the dermoepidermal junction. What is the most likely diagnosis?
一位此前身体健康的2岁男孩因持续1周的瘙痒性红斑被带到诊所就诊。皮疹出现前3天，该患儿曾患有上呼吸道感染，并被给予布洛芬治疗。体格检查发现，患儿的腿部、手臂和背部出现紧张性水疱和中央有糜烂及结痂的水肿性粉红色斑块。腋窝和腹股沟褶皱处皮肤病变密集分布。未见黏膜受累。从患儿右下背部获取的皮肤活检样本的组织病理学分析显示表皮下水疱，伴有大量中性粒细胞浸润。直接免疫荧光检查显示在真皮-表皮交界处有一条IgA线状带。最可能的诊断是什么？
A. Acute febrile neutrophilic dermatosis急性发热性中性粒细胞性皮炎
B. Dermatitis herpetiformis疱疹样皮炎
C. Erythema multiforme多形红斑
D. Henoch-Schonlein purpura过敏性紫癜
E. Linear IgA bullous dermatosis of childhood儿童线状IgA大疱性皮病
答案解析：
最终诊断为儿童线状IgA大疱性皮病。线状IgA大疱性皮病是一种罕见的自身免疫性大疱性疾病，其特征是IgA抗体在基底膜带呈线状沉积。该病可能是药物诱导的，也可能是特发性的。在儿童中，这种疾病可能需要数月甚至数年才能自行缓解。
正确答案：E
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