Neonatal pemphigus vulgaris.

Area of Science:

• Dermatology
• Immunology
• Neonatology

Background:

• Pemphigus vulgaris (PV) is an autoimmune blistering disease.
• Maternal antibodies can transfer to the fetus, potentially causing neonatal autoimmune conditions.
• Neonatal pemphigus vulgaris is a rare condition presenting with skin lesions.

Purpose of the Study:

• To report a case of neonatal pemphigus vulgaris.
• To highlight the diagnostic methods and clinical course of this rare condition.
• To discuss the management and treatment outcomes.

Main Methods:

• Clinical presentation of a neonate with blisters and erosions.
• Skin biopsy with histopathology and direct immunofluorescence for maternal diagnosis.
• Indirect immunofluorescence assays for serum antibodies against desmogleins 1 and 3 in mother and neonate.

Main Results:

• Histopathology and direct immunofluorescence confirmed pemphigus vulgaris in the mother.
• Positive serum antibodies against desmogleins 1 and 3 in both mother and neonate confirmed neonatal PV.
• The neonate's lesions resolved spontaneously within two weeks.
• The mother achieved remission after two months of rituximab treatment.

Conclusions:

• Neonatal pemphigus vulgaris is a transplacental autoimmune condition.
• Diagnostic confirmation relies on serological testing for anti-desmoglein antibodies.
• The condition typically has a benign and self-limiting course in neonates, while maternal treatment is crucial.