P11 Prolonged diagnostic journey in infantile bullous pemphigoid

Area of Science:

• Pediatric Dermatology
• Immunodermatology
• Rare Pediatric Diseases

Background:

• Infantile bullous pemphigoid (IBP) typically presents in early infancy (3-5 months) and usually responds well to treatment.
• Misdiagnosis is common due to the rarity of IBP, often leading to delayed diagnosis and treatment, as exemplified by a recent case.
• The condition is frequently mistaken for more common childhood infections like hand, foot, and mouth disease.

Purpose of the Study:

• To highlight the diagnostic challenges and delays associated with infantile bullous pemphigoid (IBP).
• To emphasize the importance of prompt referral to pediatric dermatologists for unusual infantile rashes.
• To underscore the value of clinical photography in facilitating remote specialist assessment.

Main Methods:

• Case report of a 4-month-old female infant presenting with widespread tense vesicles, bullae, and erythema.
• Diagnostic confirmation through clinical examination, histology, and direct immunofluorescence.
• Therapeutic intervention using a combination of erythromycin and oral prednisolone.

Main Results:

• The patient's clinical diagnosis of infantile bullous pemphigoid was confirmed.
• Treatment with erythromycin and prednisolone resulted in rapid improvement within two weeks.
• Complete resolution of lesions was achieved, with steroid discontinuation after eight weeks and no relapse.

Conclusions:

• Infantile bullous pemphigoid, though rare, requires prompt recognition and management by healthcare professionals.
• General practitioners and pediatricians should consider referring infants with unusual bullous eruptions for specialist dermatological evaluation.
• Utilizing clinical photographs can aid pediatric dermatologists in early diagnosis, even in remote consultations.