INTRAEPIDERMAL IGA PUSTULOSIS

Background Intraepidermal IgA pustulosis is a rare vesiculopustular co ndition characterized by intercellular IgA deposits, neutrophilic infi ltration and mild acantholysis. This condition is usually reported in middle-aged or elderly people. We present the clinical, histological a nd immunofluorescence data of a child with this condition. Observation Our case is an 11-year-old girl who presented a pruritic vesiculopust ular eruption involving the trunk, upper extremities, face and oral mu cosa. Histopathologic examination revealed an intraepidermal pustule f ormation composed of neutrophils and some eosinophils and acantholytic cells in the spinal layer. Direct immunofluorescent test showed the d eposition of IgA in the intercellular spaces throughout the whole of t he epidermis. No circulating IgA anti-intercellular antibodies were de tected by indirect immunofluorescence. She was treated with prednisolo ne 30 mg/daily. After discontinuation of corticosteroid treatment, we did not observe any skin lesions during a follow-up period of 2 years. Conclusion We consider this eruption intraepidermal IgA pustulosis (h istologically intraepidermal neutrophilic type) based on clinical and histopathological findings. Intraepidermal IEA pustulosis should be co nsidered in the differential diagnosis of vesiculopustular eruption in childhood. (C) 1997 Elsevier Science B.V.