Autoimmune bullous diseases in childhood

Autoimmune bullous diseases (AIBDs) rarely occur in childhood and in contrast to the chronic disease course in adults, often have a milder clinical course, a better treatment response and better prognosis. Although literature is scarce, several case reports and case series describe childhood cases of linear IgA disease, bullous pemphigoid, dermatitis herpetiformis, mucous membrane pemphigoid, epidermolysis bullosa acquisita, pemphigus vulgaris, pemphigus foliaceus and paraneoplastic pemphigus. Misdiagnosis and consequently delay in diagnosis is common in childhood AIBD with often initial diagnoses of infectious causes, such as hand-foot-mouth disease or impetigo bullosa. Clinical features of childhood AIBDs may overlap between subtypes, like adult cases, but the differential diagnosis is different in childhood. Another difference between the adult and childhood bullous pemphigoid is the mainly acral distribution of bullous lesions in children and the prognosis of the disease. Bullous pemphigoid and linear IgA disease might possibly be drug-induced or triggered by vaccination.