Abstract
The patient was a 5-year-old boy. He went to a local dermatologist in December 2001 as erythema and blister formation were observed on his cheeks. When Myser® (difluprednate) ointment was prescribed to him, the blisters temporarily disappeared but exacerbated later, and therefore he was admitted into our clinic. Edematous erythema and tense blisters were recognized on his face, trunk and extremities, and histopathological examination revealed subepidermal blisters. Immunofluorescence study showed linear deposits of IgG and C3 at the basal membrane zone of lesional skin. Indirect immunofluorescence microscopy revealed linear deposits on the dermal side using human skin treated with 1M NaCl as a substrate. In addition, a 290KDa protein band was recognized by an immunoblotting technique using dermal extract of normal human skin, and this condition was diagnosed as epidermolysis bullosa acquisita. This case was different from the classical type of epidermolysis bullosa acquisita in ways that the patient developed the disease in his childhood and he was quite responsive to the steroid treatment.
