Review Question - QID 109860

A 68-year-old man is brought to his primary care physician's office by his wife due to "itchy" blisters. They were gardening yesterday when her husband began complaining of generalized itching. He then woke up this morning with multiple pruritic blisters. His wife tried using calamine lotion with no significant improvement. The patient’s medical history is significant for early dementia, asthma, hypertension, and inflammatory bowel syndrome. His medications include aspirin and lisinopril. His temperature is 99°F (37.2°C), blood pressure is 121/82 mmHg, pulse is 86/min, respirations are 12/min, and oxygen saturation is 95% on room air. Physical examination shows areas of excoriation and tense bullae on his arms. A punch biopsy is obtained for immunofluorescence, which is shown in Figure A. Which of the following is associated with this patient’s most likely diagnosis?