Chronic Bullous Dermatosis of Childhood and the String of Pearls Sign

A previously well 5-year-old boy presented to the emergency department with a 1-week history of pruritic papules on both elbows that had progressed to scattered annular lesions on his buttocks, elbows, and legs with interspersed tense bullae (Figure 1). He was not receiving any medication and remained systemically well throughout. The itching had not been relieved with antihistamine. He had no infectious contacts. He had a normal cardiovascular, respiratory, and abdominal examination and was afebrile with observations appropriate for his age.

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