Dyshidrosiform pemphigoid localized on the hands in a child: a rare occurrence

Abstract

Dyshidrosiform pemphigoid is an acquired autoimmune variant of bullous pemphigoid with persistent vesicobullous eruptions localized on the palms or soles, or both. It generally occurs in the elderly and is rarely reported in childhood. Hereby, we describe the first case of dyshidrosiform pemphigoid in a 12-year-old child, which was limited to the dorsal hands and treated successfully with dapsone (diaminodiphenyl sulfone). Along with this report, we also review the clinical features of various types of dyshidrosiform pemphigoid.

Multiple itchy blisters and painful erosions on the hands

“…In the literature, cases of BP on the palmoplantar areas have been reported that were followed by the eruption spreading to the rest of the body [3]. Most cases of DP have been described in elderly patients [1], but children and young adults are also affected [4][5][6][7]. The exclusive involvement of the hands, as in our case, can be a diagnostic challenge [5,[8][9][10].…”

“…Most cases of DP have been described in elderly patients [1], but children and young adults are also affected [4][5][6][7]. The exclusive involvement of the hands, as in our case, can be a diagnostic challenge [5,[8][9][10]. Differential diagnosis includes pompholyx, allergic contact dermatitis, other bullous autoimmune diseases, epidermolysis bullosa acquisita, bullous lichen planus and porphyria cutanea tarda.…”

Dyshidrosiform Bullous Pemphigoid

“…In the group of patients with juvenile bullous pemphigoid, three had childhood bullous pemphigoid (with an onset age between one year and 18 years) and one had infantile bullous pemphigoid (with an onset age of 12 months or younger) [ 30 , 34 ]. In a comprehensive literature review of infantile and childhood bullous pemphigoid patients published in 2006 and earlier, the investigators noted the increased prevalence of blisters on the palms and soles; specifically, palmoplantar involvement of bullous pemphigoid was observed in 79% (31 of 39 patients) of infants and 17% (6 of 36 patients) of children [ 43 ].…”

“…These included dapsone (eight individuals whose dose ranged from 50 to 200 mg daily, median 150 mg daily) [ 4 , 6 , 17 , 20 , 23 , 25 , 28 , 29 ], oral antibiotics (three individuals), such as erythromycin [ 22 ], doxycycline [ 16 ] or tetracycline [ 28 ], and nicotinamide (one individual) [ 28 ]. Topical corticosteroids (17 individuals) were also used as an adjunctive therapy [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 ].…”