Female neonate, 11 days old, born by vaginal delivery at term and adequate weight for gestational age, with Apgar score 7/9, of healthy, non-consanguineous parents.
He has three healthy living brothers.
No history of maternal abortions.
Consultation with blisters, which appeared since birth, arranged in the left lower limb (LL) following the lines of Blaschko, and which increased in number with time.
Parenteral cefoxime-oxacillin (VP) is prescribed for two days, with improvement.
She was treated with high afferent, good general condition and continued with oral cefixima (VO).
Two days after discharge, new lesions of equal characteristics appear in the right LL and in the left upper limb (UL), so he is hospitalized.
Cefuroxime-oxacillin PV was restarted, smears and cultures of lesions were requested, as well as VDRL.
With the results of the negative studies it was decided to discharge and it was indicated to apply topical fusidic acid on the cutaneous vesicles and continue with cefoxime VO.
Two days after discharge from our service due to persistent lesions.
The general physical examination was within normal limits.
Dermatological physical examination revealed multiple firm vesicles affecting walls, on an inflammatory basis, with linear distribution that left UL and both LL.
The size of the lesions varies, with diameters ranging from 0.1-1 cm. No nail involvement was found.
She was referred to the neurologist and ophthalmologist, who ruled out involvement in these areas.
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Diagnostic auxiliary methods: blood count: Hb: 15.4 g/dl; leukocytes: 16 700 cells/mm3; N: 68%; L: 20%; Eo: 10%; platelets: 330 000 cells/mm.
Direct culture: negative for bacteria.
Two blood cultures were negative.
VDRL: non-reactive.
Cutaneous biopsy: An incisional skin biopsy of one of the vesicles of MI is performed, fixed in 10% neutralized formaldehyde and seated in conventional manner.
HE staining is performed.
The pathology reports: superficial perivascular psoriasiform, presence of spongiosis in the lower third of the epithelium with eosinophilic exocytosis and presence of marked dyskeratotic cells dermatitis anatomy.
In dermis, a superficial perivascular inflammatory infiltrate of lymphocytes with eosinophils and edema was observed.
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Final pathological diagnosis: incontinentia pigmenti erythematous blistering stage.
Treatment and control: lesions are located twice a day until blisters disappear.
He came to follow-up after 15 days, with marked disappearance of blisters and no new lesions appeared.
