Case Number : Case 2958 - 08 November 2021 Posted By: Dr. Mona Abdel-Halim

Spongiotic vesicle with eosinophils in a female infant suggests incontinentia pigmenti.  However, the onset is rather late and progressive course not typical.  Therefore alternative diagnoses such as a vaccination reaction must be considered.

spongiotic sub epidermal vesicle with eosinophils. description is tense blisters. Post vaccination well syndrome has been reported but presenting as tense blisters is not common. DIF data and also CBC blood counts to see whether any eosinophilia is there. if there is any special arrangement of blisters we can consider bullous dermatosis of childhood. 

Subepidermal eosinophil rich blister. LABD, although, is a neutrophilic but rarely can have eosinophils predominance. Also, uncommon but BP can have early infantile/childhood onset. DIF is needed. 

I think that this is vaccination-induced infantile bullous pemphigoid. DIF study is needed for confirmation.

On 09/11/2021 at 18:06, Anil Patki said:

I think that this is vaccination-induced infantile bullous pemphigoid. DIF study is needed for confirmation.

I liked. Agree with you. 

Found this: Baroero et al. BMC Pediatrics (2017) 17:60 DOI 10.1186/s12887-017-0813-0. 

This was diagnosed as vaccination induced infantile bullous pemphigoid