“String of Pearls” Sign revealing Linear IgA bullous disease

A 21-year-old HIV-positive male on antiretroviral treatment with daily darunavir/cobicistat and emtricitabine/tenofovir presented with a 2-week history of pruritic skin lesions on both shoulders and the face. The patient denied any other symptoms. Antiretroviral treatment had not been recently changed, his viral load was undetectable and there was no other relevant medical history. On physical examination, he was in good general health and vital signs were within normal limits. He had scant erythematous macules on both shoulders and three clear grouped vesicles on the right forehead.