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Blistering diseases in neonates

Zhao, Cathy Y.; Murrell, Dedee F.

doi: 10.1097/MOP.0000000000000381
DERMATOLOGY: Edited by Joyce M.C. Teng

Purpose of review Neonatal blistering diseases are rare yet potentially fatal. Therefore, it is crucial for clinicians to know its broad range of differential diagnoses. This review discusses the recent literature on the causes and the most appropriate clinical approach to neonatal blistering diseases.

Recent findings Neonatal infections are the commonest causes for neonatal blistering. On the other hand, autoimmune blistering diseases are extremely rare with the literature limited to case reports and one systematic review only. Inherited genodermatoses are also rare, with recent developments in epidermolysis bullosa classification.

Summary In conclusion, as neonatal infections are the commonest cause for blistering, any neonate with blistering should have their blister fluid investigated for infection, while an antimicrobial should be initiated early. Autoimmune blistering diseases should be considered in neonates with a maternal history of autoimmune blistering disease. Although pemphigus and bullous pemphigoid have overall good prognoses, linear IgA bullous dermatoses has a poor prognosis and requires aggressive treatment. Inherited genodermatoses should be suspected when there is a family history of genodermatoses or consanguinity. In this case, the clinician should not hesitate to seek dermatology advice, perform a skin biopsy and consider genetic testing.

aDermatology, St George Hospital

bMedicine, University of New South Wales, Sydney, Australia

Correspondence to Dedee F. Murrell, MA, BMBCh, FAAD, FACD, MD, FRCP, Department of Dermatology, St George Hospital, Gray St, Kogarah, Sydney, NSW 2217, Australia. Tel: +61 2 91132543; fax: +61 2 91132906; e-mail:

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