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We were interested to read the case report by Cortés-Pinto et al. describing a case of bullous pemphigoid in a 3-month-old infant following vaccination that was treated initially with systemic and topical corticosteroids, and subsequently with dapsone, with a good response. We would like to share our experience regarding a similar male infant, who at the age of 14 weeks developed an erythematous urticated and bullous eruption affecting mainly the acral regions. At the onset of the rash, the patient had been treated with topical hydrocortisone 1% and a dressings regime consisting of aspiration of the blisters, emollients, and a non-adherent dressing. Once the result confirmed an immunobullous aetiology he was commenced on oral erythromycin 125mg four times daily and topical mometasone furoate 0.1% ointment. He responded rapidly with complete clearance of his eruption. After six weeks the erythromycin was discontinued and the topical corticosteroid was rapidly tapered and stopped. There has been no recurrence of blistering after 3 months, and there have been no permanent sequelae. The use of an anti-inflammatory antibiotic in this case aligns with recent evidence in adults where doxycycline was deemed non-inferior in efficacy as compared to prednisolone as an initial treatment for bullous pemphigoid, but with significantly fewer adverse outcomes. We would like to emphasise that there may be scope for treating infantile pemphigoid with a combination of potent topical corticosteroid and oral erythromycin. The very significant advantages are that invasive monitoring investigations are not required and a much better side effect profile. This article is protected by copyright. All rights reserved.
This article was published in the following journal.
Name: Clinical and experimental dermatology
To evaluate the clinical and ultrasonographic response of periocular infantile capillary hemangioma during treatment with oral propranolol.
Pemphigus diseases (PDs) and mucous membrane pemphigoid (MMP) are a group of immune-mediated mucocutaneous disorders clinically characterized by the formation of blisters, erosions and ulcers. The ski...
Reply to: Comment on "Oral diabetes medications other than dipeptidyl peptidase-4 inhibitors are not associated with bullous pemphigoid: A Finnish nationwide case control study" and a case report of glucagon-like peptide-1 receptor agonist induced bullous pemphigoid.
Pityriasis lichenoides et varioliformis acuta(PLEVA) pemphigoides is an uncommon skin disease, which is characterized by the appearance of blistering skin lesions in patients with PLEVA. We present a ...
This is a prospective randomized, double-blind study to compare the clinical efficacy of infantile hemangioma treatment using propranolol with corticosteroids as compared to therapy with c...
This study will determine the safety of treatment of bullous pemphigoid in patients resistant to therapy with systemic corticosteroids, with rituximab plus systemic corticosteroids.
Patients diagnosed with bullous pemphigoid were confirmed based on the investigators national diagnostic criteria. Patients who meet all inclusion criteria and conflict the exclusion crite...
Bullous pemphigoid (BP) is the most common blistering auto-immune disease of skin with an incidence estimated to 400 new cases per year. Topical corticosteroid therapy is considered the st...
Bullous pemphigoid is the most common type of bullous skin disease and is clinically characterized by clear-tense bullae, which result in post-bullous cutaneous erosions, altering the skin...
An itching, autoimmune, bullous SKIN disease that occurs during the last two trimesters of PREGNANCY and PUERPERIUM. It also affects non-pregnant females with tissue of PLACENTA origin, such as CHORIOCARCINOMA; or HYDATIDIFORM MOLE. It exhibits antigenic and clinical similarity to bullous pemphigoid (PEMPHIGOID, BULLOUS). This disease does not involve herpes viruses (old name, herpes gestationis).
A chronic blistering disease with predilection for mucous membranes and less frequently the skin, and with a tendency to scarring. It is sometimes called ocular pemphigoid because of conjunctival mucous membrane involvement.
The earliest of the stages of infantile psychosexual development, lasting from birth to 12 months or longer.
A group of corticosteroids carrying hydroxy groups, usually in the 11- or 17-positions. They comprise the bulk of the corticosteroids used systemically. As they are relatively insoluble in water, salts of various esterified forms are often used for injections or solutions.
A branch of dentistry dealing with diseases of the oral and paraoral structures and the oral management of systemic diseases. (Hall, What is Oral Medicine, Anyway? Clinical Update: National Naval Dental Center, March 1991, p7-8)
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