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February 2010

Superficial Flaccid Bullae in a Female Neonate—Quiz Case

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Arch Dermatol. 2010;146(2):191-196. doi:10.1001/archdermatol.2009.366-a

A female neonate was born to healthy, nonconsanguineous parents and presented with superficial erosions surrounded by a thin collarette of scale on her abdomen, buttocks, and thighs at birth without erythroderma (Figure 1). Her family history was significant for atopic dermatitis, and her half-siblings, father, and paternal grandmother had a similar skin condition. Her sole medication was desonide, 0.05%, cream. At age 1 year, she underwent a physical examination that revealed edematous, pink plaques surrounded by thin scale on her abdomen, buttocks, and inguinal folds. There were areas of insipient vesiculation and postinflammatory hyperpigmentation on her trunk and extremities. Crusted erosions, plaques, and hyperpigmented macules covered her wrists and ankles. A punch biopsy specimen from the buttock was obtained, and histologic examination was performed with hematoxylin-eosin staining (Figure 2 and Figure 3).

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