case_images: PMC11809513_01
case_images: PMC11809513_02
case_images: Cutaneous and mucosal lesions: blisters with healing centre as also new blisters as seen on the dorsum of the foot (a), fingers (b), genital areas (c), face (d), and mucosal involvement with erosion of the soft palate (e). Subglottic and glottic oedema with erosions and fibrin deposits on false vocal cords causing partial obstruction (f).
case_images: neo-2025-0122-0001-540770_F01.jpg
case_images: PMC11809513_02_neo-2025-0122-0001-540770_F01.jpg
case_images: F1
case_images: Physical examination at admission revealed erosions in the oral cavity, and extensive skin blisters (Fig. 1). The investigations were completed by laryngo-tracheoscopy and oesophago-gastroscopy, proving oedema and erosions of the epiglottic, supraglottic, subglottic, and gastric mucosa (Fig. 1).
case_images: Immunofluorescence. a Direct immunofluorescence on the skin biopsy showing linear deposits of IgA along basement membrane zone at the derma-epidermal junction. b Split-skin indirect immunofluorescence of the mother's breastmilk.
case_images: neo-2025-0122-0001-540770_F02.jpg
case_images: PMC11809513_02_neo-2025-0122-0001-540770_F02.jpg
case_images: F2
case_images: IgA and C3 deposition along the basement membrane zone (Fig. 2) excluding IgA pemphigus. Indirect immunofluorescence with the mother's milk using salt-split skin revealed presence of IgAs attacking the basement membrane of skin and mucosa (anti-BMZ IgAs) while these antibodies were not found in mother's nor patient's serum.
case_images: PMC11809513_03