Bullous dermatosis suspected in an 8-month-old child in Guinea-Bissau

Abstract

An 8-month-old child was admitted to a paediatric intensive care unit in Guinea-Bissau with severe blistering dermatosis. He was treated with broad spectrum antibiotics and dressings, without improvement. After 2 weeks, linear IgA bullous dermatosis was suspected. Owing to lack of dapsone, the child was treated with prednisolone and improved. To avoid corticosteroids side effects, 2 months after starting prednisolone we switched to colchicine, but the boy’s condition worsened for reasons of poor adherence, requiring intravenous corticosteroids and antibiotics. After complete resolution of the skin lesions, we continued with colchicine monotherapy, then changed to dapsone after 3 months. The child did not show any further signs of dermatosis, but his follow-up ended abruptly, because he did not return to the hospital. IgA bullous dermatosis is a challenging diagnosis in settings where pathological studies cannot be conducted. Multidisciplinary treatment is required and colchicine is a good option if dapsone is not available.

Management Options for Linear Immunoglobulin A (IgA) Bullous Dermatosis: A Literature Review

“…Colchicine is an anti-inflammatory drug that inhibits neutrophil and monocyte chemotaxis as well as leukocyte adhesion. Seven case reports have been described utilizing colchicine [25][26][27][28][29][30][31]. One study by Ang and Tay [25] described the case of a five-year-old girl who developed CBDC one month after the resolution of hand-foot-mouth disease.…”

Collaboration between Médecins Sans Frontières and Oxford Medical Case Reports

“…With the publication of a case of paediatric bullous dermatosis from Guinea [1], we are very pleased to announce the launch of a collaboration among Oxford University Press, ‘Oxford Medical Case Reports’, and Médecins Sans Frontières (Doctors Without Borders). Physicians have been writing and publishing detailed descriptions of their patients’ health conditions for millennia, but the first case reports journal as we know it today was that of the Royal College of Physicians of London, instigated in the 18th century by the pioneering doctor William Heberden.…”