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DEAR EDITOR, A 5-month-old male infant presented with bullous palmoplantar lesions. He had received serogroup B meningococcal vaccination 1 week previously. Physical examination showed tense palmoplantar blisters over an erythematoedematous base (a, b). Direct immunofluorescence showed a linear deposit of IgG and C3 on the basal lamina (c). The patient was diagnosed with infantile bullous pemphigoid (IBP). IBP is an infrequent variant of this blistering disease, which usually affects acral areas. Overall, the disease outcome is favourable. 1 Cases of IBP following vaccination have been previously described. 2 This is, to our knowledge, the first reported case of IBP following serogroup B meningococcal vaccination.

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Elastosis perforans serpiginosa (EPS) is a rare condition within the group of perforating dermatoses. It is characterized by the synthesis of anomalous elastic fibers that are eliminated through perforating channels (transepidermal elimination). It is classified into three subtypes. One of them is drug‐induced by prolonged treatment with d‐penicillamine. This drug is a heavy metal chelator used to treat diseases such as rheumatoid arthritis, cystinuria, and Wilson's disease. Years of treatment with d‐penicillamine at high doses are required for developing EPS, with occasional slow regression after drug withdrawal. There is no established treatment for EPS, with described cases using various treatment options such as corticoids, retinoids, tazarotene, cryotherapy, imiquimod, photodynamic therapy, electrosurgery, and CO2 laser among others with inconsistent results. We present a case of EPS induced by d‐penicillamine with favorable response to cyclosporine and allopurinol in a patient with a history of Wilson's disease since childhood. They maybe considered as possible therapeutic options not described so far for an entity with variable response to current treatments. We highlight the extensive involvement of the case with progression, despite the suspension of d‐penicillamine and failure to previous treatments with photodynamic therapy and retinoids.