The second clinical case is that of a five-year-old girl, with no history of interest, referred by her pediatrician, for presenting successive sprouts of vesicular lesions and bullous ulcers in the perioral area for one year.
It had been, like the previous case, several times diagnosed as bullous imprint and treated with topical and oral antibiotics on numerous occasions.
Physical examination revealed vesicular lesions with serous content of approximately 3 mm in diameter in the mouth and forearms, as well as erosions in the perineal area and crusts of aspect
The girl was afflicted with good general condition and did not present mucosal lesions.
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Under suspicion of ILAD, we took biopsy of a bullous lesion of the right thigh and another healthy perilesional skin for immunofluorescence study.
Histological examination showed subepidermal detachment with abundant neutrophil and eosinophils content.
The DFA showed the presence of exclusive IgA deposit.
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Initially, treatment was established with promotions of zinc sulfate, topical pimecrolimus and oral amoxicillin/clavulanic acid.
In addition, a complete blood test was requested, as in the previous case, with normal results.
Two months after the first visit, treatment with oral cholera was started (8 mg daily), prescribed in two doses.
From then on, the sprouts have occurred, but are less intense and more sophisticated over time.
The patient remains under review with good tolerance and normal control analysis.
