A 9-year-old previously healthy boy presented with a 3-d history of progressive mildly itchy lesions over the whole body associated with low grade fever. Lesions initially started over the abdomen and then spread to involve the extremities and face with sparing of the mucosa. Physical examination revealed a generalized rash consisting of vesicles on erythematous bases as well as large tense and flaccid bullae on the lower extremities (Figs 1 and 2). Two biopsies were taken, one from a vesicle and the other from a tense bulla, which also included part of the normal skin (Fig. 3). Both specimens revealed

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