Infantile pemphigoid treated without oral corticosteroids.

08:00 EDT 16th May 2019 | BioPortfolio

Summary of "Infantile pemphigoid treated without oral corticosteroids."

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.


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Name: Clinical and experimental dermatology
ISSN: 1365-2230


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