Case reports of linear IgA bullous dermatosis of childhood

Linear IgA bullous dermatosis of childhood (LADC) is an uncommon acquired blistering skin disorder which affects young children. It is characterised by a linear band of IgA at the epidermal basement membrane on direct immunofluorescence. From 1984 to 1988 at the previous skin centre at Middle Road Hospital, and 1989 to 1997 at the present National Skin Centre, a total of 4 cases were seen. All the patients were female and their ages ranged from 5 to 14 years (mean 8 years). There were 2 Chinese, 1 Caucasian and 1 Malay. All presented with an acute onset of blistering of 1 to 3 weeks' duration. Their skin biopsies showed subepidermal bullae with neutrophils, with/without eosinophils and direct immunofluorescence tests revealed linear deposits of IgA along the dermoepidermal junction. All were treated with prednisolone and dapsone with good results. One patient developed dapsone-induced haemolysis and treatment was changed to colchicine. We review the epidemiology, aetiology, current concepts and treatment modalities of this condition.