Childhood pemphigus initially seen as eosinophilic spongiosis.
The condition of a 3-year-old boy with an intermittent, generalized, bullous eruption was initially diagnosed as (and treated as) bullous impetigo. After a relapse, two skin biopsies were performed. Each biopsy specimen showed the changes of eosinophilic spongiosis. A third biopsy specimen was also examined by direct immunofluorescence microscopy. The specimen showed deposition of IgG in the intercellular region of the epidermis. The patient's serum contained intercellular antibodies in a dilution of 1:160, confirming the diagnosis of pemphigus. A biopsy should be performed in the case of a child with a persistent or recurring bullous eruption; immunofluorescence microscopy of the biopsy is essential.
D002675:Child, Preschool; D003937:Diagnosis, Differential; D004802:Eosinophilia / Q000209:etiology*; D006801:Humans; D007169:Impetigo / Q000175:diagnosis; D008297:Male; D010392:Pemphigus / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis* / Q000473:pathology