#derma #path

A 70-year-old male patient with a past medical history of diabetes mellitus with signs of diabetic nephropathy presented with a sudden severe itch and generalized papules and nodules. Physical examination revealed central keratotic plaques with no blisters. Direct immunofluorescence showed linear deposition of IgG and C3c at the dermo-epidermal junction. Histopathological examination of a skin biopsy specimen revealed a cup-shaped invagination of the epidermis associated with necrotic debris. There were vertically penetrating collagen bundles located between dermis and epidermis associated with a dermal neutrophilic infiltrate. What is the cause of pruritus in this case?

1.Bullous pemphigoid
2.Acquired reactive perforating dermatosis
3.Kyrle disease
4.Prurigo nodularis

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