Hydroa Vacciniforme: When and How to Suspect It

Hydroa vacciniforme (HV) is a rare pediatric photosensitive dermatosis characterized by sun-induced recurrent lesions on exposed areas and subsequent atrophic scarring, with its pathogenesis remaining unclear. This report aims to improve clinicians' recognition of pediatric HV and provide practical references for its clinical diagnosis and management by detailing a typical case in a young child. We describe a 3-year-old male patient with recurrent erythema, blisters, erosion, crusts, and atrophic scars on the face, nasal dorsum, and auricles for over one year. His skin lesions worsened significantly after sun exposure, alleviated with strict photoprotection, and presented with obvious seasonal variations. A definitive diagnosis of HV was made based on the patient's typical clinical manifestations. The patient was treated with strict sun avoidance, oral vitamin B6, and topical fusidic acid, with notable clinical improvement during follow-up. This case highlights that the definitive diagnosis of pediatric HV relies on typical clinical manifestations combined with the exclusion of relevant differential diagnoses, which is crucial for the early identification and standardized management of this rare disease in young children.