Abstract: 【Abstract】 Objective To summarize clinical, histopathological, immunoserological, and therapeutic features of patients with autoimmune subepidermal bullous diseases characterized by annular erythema and blisters. Methods Clinical data were collected from patients with autoimmune subepidermal bullous diseases characterized by annular erythema and blisters in the Hospital of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College from 2015 to 2022, and their clinical, pathological, immunoserological and therapeutic characteristics were retrospectively analyzed. Results A total of 25 patients were enrolled, including 10 males and 15 females, aged 39.21 ± 24.65 years; there were 9 patients with linear IgA bullous dermatosis （LABD）, 7 with bullous pemphigoid （BP）, 5 with anti-P200 pemphigoid and 4 with epidermolysis bullosa acquisita （EBA）, and 20（80%） patients suffered from pruritus to different extents. Dermal eosinophil infiltration was observed in 15 （60%） patients, elevated peripheral blood eosinophil counts in 11（44%）, and both were observed in 7（28%）. Indirect immunofluorescence on salt-split skin and Western blot analysis showed that both IgG and IgA anti-basement membrane zone antibodies were present in 9 patients, including 4 with BP, 1 with LABD, 2 with anti-P200 pemphigoid, and 2 with EBA; and multiple antibodies against different basement membrane zone antigens were present in 5. All the 7 BP patients were treated with systemic glucocorticoids, including 5 （71.4%） receiving combined immunosuppressive agents, and 2 receiving combined minocycline; the patients with LABD, anti-P200 pemphigoid or EBA were sensitive to anti-inflammatory drugs and dapsone. Conclusion Multiple types of autoimmune subepidermal bullous diseases may manifest as annular erythema and blisters, and it is necessary to make a differential diagnosis based on immunoserological tests.

Key words: Skin diseases, vesiculobullous, Autoimmune diseases, Eosinophils, Immunoglobulin A, Annular lesions