Penfigoide ampolloso infantil en relación con la vacunación hexavalente, meningococo y neumococo / Infantile bullous pemphigoid developing after hexavalent, meningococcal and pneumococcal vaccinations

El penfigoide ampolloso es una enfermedad ampollosa adquirida, autoinmunitaria, extremadamente infrecuente en los niños, que se caracteriza por la presencia de anticuerpos IgG dirigidos contra antígenos de la zona de la membrana basal. En general, el curso clínico de esta entidad es muy bueno y no presenta recaídas. El diagnóstico y el tratamiento precoces son fundamentales. Presentamos el caso clínico de una lactante de 3 meses con aparición de lesiones ampollosas en ambas palmas y plantas, y lesiones urticariformes en el tronco y la cara 3 semanas después de la vacunación de los 2 meses (hepatitis B, difteria, tétanos, tos ferina, poliomielitis, Haemophilus influenzae B, meningococo C y neumococo). La clínica empeoró con la vacunación a los 4 y 6 meses de edad. Con deflazacort por vía oral a dosis de 1 mg/kg/día se controlaron las lesiones, interrumpiéndose el tratamiento de forma progresiva a los 3 meses. Tras 8 meses de seguimiento, la niña no ha presentado recidivas. El penfigoide ampolloso se ha relacionado con la ingesta de fármacos y con las vacunaciones, apareciendo las lesiones de 1 día a 4 semanas después. Aunque el mecanismo etiopatogénicono está demostrado, se aporta un caso con una relación clara con la vacunación (AU)

Bullous pemphigoid is an acquired autoimmune blistering disorder extremely uncommon in children, characterized by circulating IgG antibodies to antigens of the epidermal basement membrane zone. In general, the clinical course of this condition is good and relapses are rare. The early diagnosis and treatment are fundamental. We present a 3-month-old girl with a blistering eruption on her palms and soles, and urticarial plaques on trunk, and face, 3 weeks after vaccine at two months (hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B, meningococcal C, pneumococcus). The clinical course worsened with vaccinations at 4 and 6 months. The control of lesions was achieved with oral deflazacort 1 mg/kg/day, with a gradual decrease until 3 months of therapy. The patient is still in remission after 8 months of follow-up. Bullous pemphigoid has been connected with some drugs and vaccinations, 1 day to 4 weeks after receiving immunization. Although the exact mechanism of induction is unclear, this case report has a visible relationship with vaccinations (AU)

[Infantile bullous pemphigoid developing after hexavalent, meningococcal and pneumococcal vaccinations]. / Penfigoide ampolloso infantil en relación con la vacunación hexavalente, meningococo y neumococo.

Bullous pemphigoid is an acquired autoimmune blistering disorder extremely uncommon in children, characterized by circulating IgG antibodies to antigens of the epidermal basement membrane zone. In general, the clinical course of this condition is good and relapses are rare. The early diagnosis and treatment are fundamental. We present a 3-month-old girl with a blistering eruption on her palms and soles, and urticarial plaques on trunk, and face, 3 weeks after vaccine at two months (hepatitis B, diphtheria, tetanus, pertussis, polio, Haemophilus influenzae B, meningococcal C, pneumococcus). The clinical course worsened with vaccinations at 4 and 6 months. The control of lesions was achieved with oral deflazacort 1 mg/kg/day, with a gradual decrease until 3 months of therapy. The patient is still in remission after 8 months of follow-up. Bullous pemphigoid has been connected with some drugs and vaccinations, 1 day to 4 weeks after receiving immunization. Although the exact mechanism of induction is unclear, this case report has a visible relationship with vaccinations.