Bullous pemphigoid (BP) is an acquired sub-epidermal immune-mediated blistering disease associated with a humoral and cellular response directed against self-antigens. Childhood BP is uncommon with only <80 reported cases in literature.Often,  lesions of childhood BP are localized rather than widespread; and, acral distribution is more common among infants. Clinically, it is often confused with chronic bullous disease of childhood (CBDC). BP can be differentiated from CBDC by the presence of immunoglobulin (Ig) G antibodies, rather than IgA at the basement membrane zone on direct immunofluorescence (DIF). We present a case of childhood BP in a one-year-old baby girl who presented with CBDC-like lesions. DIF showed IgG and C3 at the basement membrane zone. Treatment given included topical and oral sterioids due to the extent of lesions as well as antihistamine to reduce pruritus. Most of the lesions improved after two weeks and 80% resolved after two month of treatment with no note of scarring. However, continuous monitoring of the patient is advised due to the need for long-term treatment of these patients.

Human ; Female ; Infant ; Autoantigens ; Basement Membrane ; Blister ; Cicatrix ; Histamine H1 Antagonists ; Immunoglobulin A ; Immunoglobulin G ; Linear Iga Bullous Dermatosis ; Pemphigoid, Bullous ; Pruritus

Background: Ophthalmologic evaluation is often neglected in routine screening of Hansen’s disease patients. In line with the global aim of reducing grade 2 disability, eye examination should be an essential part of routine examination of Hansen’s disease patients. Objective: To describe the ophthalmologic profile of patients with Hansen’s disease seen in a tertiary hospital. Methods: A point-prevalence survey was conducted. Sixty-six Hansen’s disease patients, aged 18 and above, underwent complete ophthalmologic examination including visual acuity, refraction, external eye examination, intraocular pressure determination, dilated pupil examination, palpebral aperture measurement, corneal sensation testing, and tear breakup time determination. Statistical analysis was done. Results: All patients had ocular findings with lepromatous leprosy (62%) being the highest. Fifty-three percent had Type 2 lepra reaction. Most were males, disease duration in majority was < 5 years and bacillary morphologic index was 4.0 – 4.99. Patients with Grade 1 and Grade 2 disability of the eyes were 62% and 17% respectively. The most common ocular complications were: abnormal tear breakup time (79%), cataracts (53%),blepharitis (47%), madarosis (39%) and corneal opacities (24%). Conclusion There is a significant number of ocular findings among leprosy patients in this study. The highest number of ocular complications is among patients in the lepromatous pole. There is a preference of M. leprae for cooler areas; hence, the anterior chamber was greatly affected.
Leprosy