Blistering Blunders

Document Type

Conference Proceeding - Restricted Access

Publication Date

5-9-2025

Abstract

Patient is a 3-year-old male admitted for progressive bullous rash of face, groin, and lower extremities lasting for 2 weeks. Bullae were tense with clear fluid and had pink annular rings surrounding the scabs after bursting. Patient failed outpatient antibiotics for treatment of bullous impetigo including mupirocin, Keflex, and Augmentin. Of note, patient has been treated for multiple similar skin rashes in the past with resolution of rash after a course of oral steroids. During admission, patient continued to have new bulla develop despite receiving IV ceftriaxone, IV clindamycin, and topical mupirocin for 2 days which was concerning for non-infectious etiology. Furthermore, multiple wound cultures were negative. CBC was significant for elevated lymphocytes at 8160 and eosinophils at 2510 which was concerning for autoimmune etiology. Biopsies of the bulla revealed linear IgA deposition under direct immunofluorescence which is diagnostic for chronic bullous disease of childhood.

Comments

2025 Research Day Corewell Health West, Grand Rapids, MI, May 9, 2025. Abstract 1822

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