Menstrual disorders are common in adolescence and can have significant consequences on future reproductive health.

No abstract

A 35‐day‐old baby girl presented with a history of sudden onset of skin lesions of 4 days’ duration. The skin lesions initially appeared on the cheeks, but progressed to involve the trunk and limbss within 4 days. There was a history of upper respiratory tract infection 10 days prior to the onset of the skin lesions. The skin lesions were associated with fever. There was no history or symptoms suggestive of systemic involvement. The child was not on any drugs prior to the onset of the skin lesions. On examination, the child was febrile with a temperature of 100 °F and a pulse rate of 120 beats/min, and weighed 3.8 kg. Cutaneous examination revealed multiple, erythematous, nodular lesions on the face (Fig. 1). A few large bullous lesions were present on the thighs and gluteal region. Multiple tender nodules and a few annular lesions with well‐defined discrete papules at the margins and central erythema were also seen on the trunk and limbs. There was no involvement of the mucous membranes. Systemic examination was within normal limits. Figure 1  Face showing erythematous nodular lesions The investigations revealed a hemoglobin of 7.2 g%, a total count of 30,000 cells/mm3 with a differential count of 79% neutrophils, and an erythrocyte sedimentation rate of 50 mm at 1 h. Urine examination, USG, and pus culture were normal. Human immunodeficiency virus (HIV) screening in the baby and mother was negative. The histopathologic section revealed a dense inflammatory cell infiltrate involving the epidermis and upper dermis, composed mainly of neutrophils. The epidermis also showed edema and spongiotic vesicles. The inflammatory cell infiltrate was distributed around small blood vessels, as well as the entire upper dermal tissue, together with leukocytoclasis (Fig. 2). 2 Histopathology of a nodule showing perivascular and upper dermal neutrophilic infiltrate with leukocytoclasis and spongiosis of the epidermis (× 40) The baby was treated with oral prednisolone, at a dose of 1 mg/kg body weight, and oral potassium iodide (100%), five drops, three times daily. With this regimen, the skin lesions regressed in 4 weeks. Steroids were gradually tapered and oral potassium iodide was continued for four more weeks and then stopped. The lesions resolved with secondary cutis laxa. There was no relapse at the end of a follow‐up period of 12 months.

Pemphigus vulgaris is an autoimmune bullous dermatosis affecting skin and mucous membrane.2 It affects all races and both sexes equally. It is common during the 5th and 6th decade of life.3 It is exceedingly rare in pregnancy 5 and is associated with increased maternal morbidity and poor neonatal outcome. 4 We do report a case of pemphigus vulgaris with pregnancy. She conceived during the active phase of the disease and treated with steroids throughout pregnancy. She delivered a live preterm, appropriate for gestational age and constitutionally small fetus.

This work was carried out in collaboration between all authors. Author KPS had carried out the study and revised the article critically for important intellectual content. Author NK contributed to the conception and design of the study and overall study supervision. Author KP was assisted in conception and design of the study, interpretation of data. Author KR was responsible for the data analysis, drafted the article, statistical analysis. All authors read and approved the final manuscript.