[Bullous autoimmune disorders in children]

Hautarzt. 2013 Jun;64(6):447-55; quiz 456-7. doi: 10.1007/s00105-013-2536-y.
[Article in German]

Abstract

We review the pathogenesis, clinical features, diagnosis, differential diagnosis, and therapy of autoimmune bullous skin diseases of childhood, especially of the most common linear IgA dermatosis. In autoimmune bullous diseases, autoantibodies are formed against different adhesion molecules of the skin. These are not only pathophysiologically relevant, but also serve as basis for diagnosis and follow-up of these diseases. In case an autoimmune bullous disease is suspected, histopathology and immunohistopathology (direct immunofluorescence microscopy) as well as serological tests (indirect immunofluorescence microscopy, ELISA, immunoblot) should be performed. Therapy depends on the diagnosis. In IgA-mediated pathogenesis, dapsone can be successfully used. In IgG-mediated diseases, immunosuppression with corticosteroids and steroid-sparing agents should be initiated, although only local therapy is sufficient to control a self-limiting pemphigus neonatorum. In dermatitis herpetiformis, a life-long gluten-free diet is recommended.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Autoimmune Diseases / diagnosis*
  • Autoimmune Diseases / immunology
  • Autoimmune Diseases / therapy*
  • Child
  • Child, Preschool
  • Dapsone / therapeutic use
  • Diet Therapy / methods*
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Infant
  • Infant, Newborn
  • Male
  • Skin Diseases, Vesiculobullous / diagnosis*
  • Skin Diseases, Vesiculobullous / immunology
  • Skin Diseases, Vesiculobullous / therapy*

Substances

  • Adrenal Cortex Hormones
  • Immunosuppressive Agents
  • Dapsone