Childhood vesiculobullous eruptions: a case report of a rareconundrum

Belgaumkar, Vasudha A.; Raj, Rachana; Pradhan, Shekhar; Nile, Snehal; Bhale, Gauri

doi:10.22034/ijd.2024.413921.1751

Childhood vesiculobullous eruptions: a case report of a rareconundrum

Document Type : Case Report

Authors

Vasudha A. Belgaumkar

Rachana Raj

Shekhar Pradhan

Snehal Nile

Gauri Bhale

Department of Dermatology, Venereology and Leprosy, B. J. Govt. Medical College, Pune, India

https://doi.org/10.22034/ijd.2024.413921.1751

Abstract

Pemphigus vulgaris is a severe autoimmune disorder with blistering of the skin and mucous membranes due to antibodies targeting desmoglein 3. It typically manifests in adults between 40 and 50 years of age, with a higher prevalence in females. Presentation in children is rare and poses greater challenges in diagnosis and management. Childhood pemphigus vulgaris, a variant affecting children under 12 years old, accounts for a small proportion of vesiculobullous eruptions in the pediatric population. The most common condition in the differential diagnosis of childhood vesiculobullous eruptions is chronic bullous disease of childhood (CBDC). Here, we describe a seven-year-old girl who presented with vesicles, flaccid bullae, and erosions with crusting over the body, accompanied by oral mucosal involvement. Skin biopsy revealed the characteristic suprabasal cleft with a tombstone appearance, while direct immunofluorescence demonstrated a fishnet pattern, confirming the diagnosis of childhood pemphigus vulgaris. She was successfully treated with intravenous antibiotics, tapered systemic corticosteroids, and azathioprine.

Keywords

pemphigus

childhood

azathioprine

direct immunofluorescence