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Article
January 1994

Vesicles and Bulla in an Infant

Author Affiliations

University of Michigan, Ann Arbor, and University of California, Irvine

Arch Dermatol. 1994;130(1):110. doi:10.1001/archderm.1994.01690010115021
Abstract

REPORT OF A CASE  Five days before admission, a 9-month-old Hispanic girl had small ''bumps'' on her thigh that spread overnight to most other parts of her body. Two days later, much larger lesions developed that were described as water-filled and easily ruptured.Physical examination on admission showed two distinct types of lesions. There were multiple 0.5-cm vesicles and pustules on an erythematous base that were scattered on the extremities and soles (Figure 1). Larger flaccid bullae and denuded areas were also found on the trunk, extremities, and face (Figure 2). Biopsy specimens of the vesicle (Figure 3) and bullae (Figure 4) were obtained.What is your diagnosis?

DIAGNOSIS:  Bullous varicella (chicken pox complicated by bullous impetigo).

HISTOPATHOLOGIC FINDINGS  Microscopic examination of the vesicle (Figure 3) showed an intraepidermal vesicle with acantholysis and multinucleated giant cells. Epidermal cells exhibited both reticular and ballooning regeneration. Examination of

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