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June 1997

Vesicobullous Lesions in a Child

Author Affiliations

Kerpel-Fronius Ödön Children's Hospital (Drs Nyul and Harangi) and the University Medical School (Drs Várszegi and Zombai), Pécs, Hungary

Arch Dermatol. 1997;133(6):779-780. doi:10.1001/archderm.1997.03890420121018

REPORT OF A CASE  A maculopapular eruption appeared on the trunk of a 2½-year-old boy after he had been treated with penicillin for tonsillopharyngitis. The rash progressed even though the penicillin therapy was discontinued. Vesicobullous lesions subsequently developed on the patient's face, trunk, and extremities and then spread to his scalp, soles, palms, and oral mucous membranes (Figure 1 and Figure 2). Physical examination revealed tense blisters of various size arising on an erythematous base. In some places, new vesicles were seen around older, crusted erosions (Figure 3). Nikolsky sign was absent. The complete and differential blood cell counts and the IgE level were normal. A skin biopsy specimen was obtained (Figure 4).What is your diagnosis?Vesicobullous Lesions in a Child

DIAGNOSIS:  Bullous pemphigoid (BP).

HISTOPATHOLOGIC FINDINGS AND CLINICAL COURSE  The diagnosis of bullous pemphigoid was established by histologic examination and immunofluorescence findings. Light microscopic examination of the biopsy