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HistoryA previously healthy 30-year-old G2P1 African-Americanwoman, at 11 weeks’ gestation, presented with a three-week history of painful and pruritic blisters on her trunkand upper extremities. She had no drug allergies and wastaking only prenatal vitamins.Physical examination revealed multiple intact flaccidbullae and large erosions. On closer inspection, therewere smaller vesicles arranged in an annular configurationand violaceous patches with overlying crust (Fig. 1). Mul-tiple erosions were present on the oral mucosa.Laboratory data revealed a normal blood count andmetabolic panel. Her antinuclear antibody titer wasslightly elevated at 1 : 160. However, her anti-double-stranded DNA antibodies were normal.Two punch biopsy specimens were submitted to derma-topathology (Figs. 2 and 3).

A healthy infant of an Ethiopian origin presented with yellow nodules on the maxillary alveolar ridge (Fig. 1). Punch biopsy specimens obtained from the lesions on the second day of life confirmed the diagnosis of inclusion cysts (Fig. 2). Follow-up at 2 months of age did not reveal any changes in the morphology of the lesions. Subsequently, the nodules resolved spontaneously.

Pruritus remains a significant complication of end-stage renal disease. Its cause in hemodialysis patients is not known. It has been postulated that increased numbers of mast cells occur in these patients and may account for the presence of pruritus. Our objective was to determine if there is a difference in the number of cutaneous mast cells between pruritic and nonpruritic patients. A 3-mm punch biopsy specimen was obtained from pruritic (n = 7) and nonpruritic (n = 6) hemodialysis patients. We observed no significant difference in the quantity of cutaneous mast cells in pruritic and nonpruritic hemodialysis patients. We conclude that the etiology of pruritus in hemodialysis patients is not related to an increase in the number of cutaneous mast cells.