OBIORA-EZE DIKE IM-535 19/07/2021

Passport Data
Sex:- Male

Complaints

History
● Gravida 1, Para 1,
● Birth weight is 3180g
● Born after 40 weeks
● Infant was full of life and had an APGAR score of 9 at one
minute and 10 at 5 minutes.
● Mother was diagnosed with pemphigus vulgaris 4 years prior
to the child’s birth.
● Infant was born after a spontaneous vertex delivery
● Mother has negative serologies for congenital infections.
● Before pregnancy, the mother had lesions on her skin and
underarms. After performing a skin biopsy it was revealed
she has pemphigus vulgaris. Since then she has gone to the
dermatologist and has been taking azathioprine up until
pregnancy was confirmed and also took prednisolone during
the whole pregnancy period.
● Disease became active during the second trimester but it
went into remission for a period of time after increasing
the dose of corticoid.

Objective Examination
● He was in good general condition when he was admitted/
● He was active and reactive plus he had preserved capillary
perfusion, he was eupneic and he had no apparent
malformations.
● Patient had a rounded lesion on his chest. It was 4cm in
diameter which had an erythematous base. It also had scaly
borders with vesicles, bubbles and crusts permeating inside.
● Child also had extensive lesions with similar
characteristics just like the one on his chest
● Mucous membrane were intact
 ● Nikolsky sign was negative(skin finding in which the top
layers of the skin slip away from the lower layers when
rubbed).
●

Plan of Investigation
● CBC
● Biochemical Blood Analysis
● Skin biopsy
● Indirect immunofluorescence

Lab Results
● Normal CBC
● Skin biopsy revealed erythematous base. It also had scaly
borders with vesicles, bubbles and crusts permeating inside.
Marked leukocytic infiltrate, neutrophils and eosinophils in
the dermis.

Diagnosis
Pemphigus Neonatorum

Treatment
● Corticosteroids
● IV immunoglobulin
● Steroid-sparing immunosuppressive drugs(azathioprine,
cyclophosphamide)