The first clinical case is that of a three-year-old boy with a history of atopic dermatitis and allergy to cow's milk proteins, who came to our clinic for pruritic lesions of one week duration.
The physical examination revealed vesicular lesions and blisters tenbellon, with serohelix sealants and seals with melicérico aspect on the surface, located in the buttocks, posterior auricular face in both paws.
The patient was afflicted with good general condition, without mucosal involvement.
Parents affirmed that the child had presented several similar episodes five months ago with the diagnosis of bullous impetigo and had been treated with several topical antibiotics, without response.
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Under suspicion of other childhood bullous dermatoses, we performed a skin biopsy of one ampoule and another on healthy perilesional skin for direct immunofluorescence (DIF).
The histological sample showed subepidermal detachment with abundant neutrophil and eosinophils content.
DFA showed linear deposits of immunoglobulin A (IgA), being negative for IgM, IgG and C3.
Treatment was established with betamethasone/ fusidic acid cream and oral prednisone at a dose of 0.5 mg/kg/day, four days and on a descending regimen.
The lesions were resolved within ten days.
Laboratory tests were also ordered including complete blood count, general biochemistry, sediment, antinuclear antibodies ANA), antinuclear leukocyte dehydrogenase (ASLO), rheumatoid factor, antitransglutaminase-6, C-reactive protein.
Treatment with antibiotics was not necessary due to early remission of the sprouts.
After one year of follow-up, the patient has not presented skin lesions again.
