Conference Material > Slide Presentation
Ilyas A
MSF Paediatric Days 2022. 2022 December 1; DOI:10.57740/48P1-N928
Conference Material > Video (talk)
Ibrahim AI
MSF Paediatric Days 2022. 2022 December 1; DOI:10.57740/3n8y-wc55
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Conference Material > Abstract
Ibrahim AI, Valori AV, Aderie EM
MSF Paediatric Days 2022. 2022 November 26; DOI:10.57740/v0ej-8d09
INTRODUCTION
Immunobullous disorders include several uncommon skin disorders rarely seen in infants. They typically present with bullae, erosions and surrounding erythema, although many variants and clinical presentations exist. We report the case of an infant with extended skin lesions who was diagnosed clinically and successfully treated after remote support from a dermatologist.
CASE DESCRIPTION (Download PDF for photos accompanying this description)
A 4-month-old boy arrived at our hospital with his mother presenting with diffuse, irregular skin erosions on the face, chest, shoulder and scalp. The condition started when the infant was 40 days old with flaccid, clear blisters on his left cheek. These ruptured to produce itchy, irregular-shaped erosions with thick crusts, and pustules at the edges. The lesions extended to the present locations including mucous membranes of the mouth and conjunctiva. There was no history of maternal skin disease or pregnancy complications. He was delivered at home and was previously healthy. Family history revealed that two older siblings had exhibited similar symptoms at 2 months, and 40 days old, and died at 8 and 4 months old respectively. The case was discussed remotely with a dermatologist using telemedicine, and the diagnosis of immunobullous disorder was made on clinical suspicion. In addition to IV cloxacillin and nutritional support, oral prednisone 2mg/kg and wound care were started. After 14 days he improved clinically, and the lesions started to heal.
DISCUSSION
We report a case of an infant with a clinical diagnosis of immunobullous disorder, successfully treated with oral corticosteroids. Differential diagnosis of skin disorders in settings without laboratory capacity for histopathology is challenging, but subspecialist support via telemedicine allowed the team to start empiric treatment resulting in clinical improvement and discharge of a complicated case. Remote health advice platforms are important tools to improve quality of care for patients in low resource settings.
Immunobullous disorders include several uncommon skin disorders rarely seen in infants. They typically present with bullae, erosions and surrounding erythema, although many variants and clinical presentations exist. We report the case of an infant with extended skin lesions who was diagnosed clinically and successfully treated after remote support from a dermatologist.
CASE DESCRIPTION (Download PDF for photos accompanying this description)
A 4-month-old boy arrived at our hospital with his mother presenting with diffuse, irregular skin erosions on the face, chest, shoulder and scalp. The condition started when the infant was 40 days old with flaccid, clear blisters on his left cheek. These ruptured to produce itchy, irregular-shaped erosions with thick crusts, and pustules at the edges. The lesions extended to the present locations including mucous membranes of the mouth and conjunctiva. There was no history of maternal skin disease or pregnancy complications. He was delivered at home and was previously healthy. Family history revealed that two older siblings had exhibited similar symptoms at 2 months, and 40 days old, and died at 8 and 4 months old respectively. The case was discussed remotely with a dermatologist using telemedicine, and the diagnosis of immunobullous disorder was made on clinical suspicion. In addition to IV cloxacillin and nutritional support, oral prednisone 2mg/kg and wound care were started. After 14 days he improved clinically, and the lesions started to heal.
DISCUSSION
We report a case of an infant with a clinical diagnosis of immunobullous disorder, successfully treated with oral corticosteroids. Differential diagnosis of skin disorders in settings without laboratory capacity for histopathology is challenging, but subspecialist support via telemedicine allowed the team to start empiric treatment resulting in clinical improvement and discharge of a complicated case. Remote health advice platforms are important tools to improve quality of care for patients in low resource settings.