10th August 2020

A 63-year-old man presents to secondary care complaining of intense pruritus and a blistering rash

A 63-year-old man presents to secondary care complaining of intense pruritus and a blistering rash. On questioning, the rash has been present for 3 months but has deteriorated over the last few days with development of a number of tense, fluid-filled blisters on his arms and legs. On examination, you note a number of large, tense bullae on all 4 limbs with a background of intense, patchy erythema. 

Which of the following would be seen on skin biopsy for direct immunofluorescence?

Select the SINGLE most appropriate option from the list below. Select ONE option only.