A 4-year-old boy presents with recurrent tense blisters and annular plaques with new vesicles arranged along the rim, described as a cluster of jewels, around the genitalia and perioral region. Direct immunofluorescence shows linear IgA deposition at the basement membrane zone. What is the diagnosis?
- A Bullous impetigo
- B Dermatitis herpetiformis
- C Chronic bullous disease of childhood ✓
- D Childhood bullous pemphigoid
Correct answer: C. Chronic bullous disease of childhood
Explanation
Chronic bullous disease of childhood is the paediatric form of linear IgA bullous dermatosis. The string of pearls or cluster of jewels arrangement of vesicles at the edge of annular plaques, in a periorificial and perineal distribution, is its signature morphology, supported by linear basement membrane zone IgA. Dermatitis herpetiformis shows granular papillary IgA on extensor surfaces without annular rosettes. Bullous impetigo is culture-positive with staphylococci, and bullous pemphigoid shows linear IgG and A3.
Reference: Rook's Textbook of General Dermatology, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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