An infant with bullous pemphigoid.
Bullous pemphigoid is the most common subepidermal autoimmune blistering disease. However, it is very rare in the pediatric population. A 5-month-old male infant presented with multiple bullae located on palms and soles. Complete blood count revealed relative eosinophilia . A biopsy revealed a subepidermal blister present along with a dermal mononuclear infiltrate rich in eosinophils. In focal areas collagen flame figures, were also observed. Direct immunofluorescence showed linear reactivity for C3c and IgG at the dermal-epidermal junction. IgA was not found. Complete resolution was achieved after oral deflazacort (1.5mg/kg/day) with progressive dose reduction over 2 weeks. Bullous pemphigoid is extremely rare in the infant. In our case the disease presented with an unusual localized (acral) clinical distribution and a favorable outcome.
Santos
António Luís
AL
Dermatology Department, Hospital de São João and Faculty of Medicine of Oporto, Portugal.
Mota
Alberto Vieira
AV
Ramon
José
J
Lopes
José Manuel
JM
Azevedo
Filomena
F
D000284:Administration, Oral; D000287:Administration, Topical; D000888:Antibodies, Anti-Idiotypic / Q000276:immunology; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D019084:Fluorescent Antibody Technique, Indirect; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007223:Infant; D008297:Male; D010391:Pemphigoid, Bullous / Q000175:diagnosis* / Q000188:drug therapy; D011282:Pregnenediones / Q000008:administration & dosage; D012008:Recurrence; D012867:Skin / Q000276:immunology / Q000473:pathology
D000888:Antibodies, Anti-Idiotypic; D005938:Glucocorticoids; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D011282:Pregnenediones; C021988:deflazacort