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[Chronic bullous dermatosis in childhood. Association with salmonella enteritis]
J C Simon1, A Dietrich, A Kapp
1Universitäts-Hautklinik, Freiburg.
Insights
A rare pediatric skin condition, chronic bullous disease of childhood (CBDC), presented atypically after Salmonella infection and antibiotic treatment. Prompt dapsone therapy resolved the blistering lesions, offering insights into CBDC management.
Area of Science:
- Pediatric Dermatology
- Immunodermatology
- Infectious Disease Complications
Background:
- Chronic bullous disease of childhood (CBDC) is a rare autoimmune blistering disorder.
- The case highlights a potential link between Salmonella enteritidis infection and the onset of CBDC symptoms.
- Antibiotic treatment for infection may precede or trigger typical CBDC manifestations.
Observation:
- A 2-year-old girl with suspected CBDC developed lesions after Salmonella enteritidis infection and antibiotic therapy.
- The lesions initially resembled impetigo contagiosa before progressing to typical CBDC symptoms.
Findings:
- Diagnosis of CBDC was confirmed by linear IgA deposition on direct immunofluorescence.
- The patient's blistering lesions resolved rapidly with dapsone treatment.
Implications:
- This case highlights a potential link between Salmonella infection, antibiotic treatment, and CBDC onset.
- It underscores the importance of considering atypical presentations and effective treatment options like dapsone for CBDC.
Abstract:
We report on a 2-year-old girl with chronic bullous disease of childhood (CBDC). Concomitantly with a feverish gastrointestinal infection caused by Salmonella enteritidis, the child presented with lesions resembling impetigo contagiosa on the legs and face. Following antibiotic treatment with cephalosporins p.o. and flucloxacillin i.v. she developed typical symptoms of CBDC, i.e. tense blisters on erythematous skin in the perineal area, on the flexor aspects of the thighs and upper arms and on the face. Direct immunofluorescence revealed a linear IgA deposition along the basement membrane zone, confirming the diagnosis of CBDC. These lesions cleared rapidly after treatment with dapsone p.o. This case prompted us to consider new aspects of the pathogenesis, clinical entity and treatment of this rare bullous disease of childhood.