Zhao Cathy Y, Murrell Dedee F
aDermatology, St George HospitalbMedicine, University of New South Wales, Sydney, Australia.
Curr Opin Pediatr. 2016 Aug;28(4):500-6. doi: 10.1097/MOP.0000000000000381.
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.
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.
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.
新生儿水疱性疾病虽罕见但可能致命。因此，临床医生了解其广泛的鉴别诊断至关重要。本综述讨论了有关新生儿水疱性疾病病因及最合适临床处理方法的近期文献。
新生儿感染是新生儿水疱形成最常见的原因。另一方面，自身免疫性水疱性疾病极为罕见，文献仅限于病例报告和一篇系统评价。遗传性皮肤病也很罕见，大疱性表皮松解症分类有了新进展。
总之，由于新生儿感染是水疱形成最常见的原因，任何有水疱的新生儿都应检查疱液以排查感染，并应尽早开始使用抗菌药物。有自身免疫性水疱性疾病母亲病史的新生儿应考虑自身免疫性水疱性疾病。尽管天疱疮和大疱性类天疱疮总体预后良好，但线状IgA大疱性皮病预后较差，需要积极治疗。有遗传性皮肤病家族史或近亲结婚史时应怀疑遗传性皮肤病。在这种情况下，临床医生应毫不犹豫地寻求皮肤科建议，进行皮肤活检并考虑基因检测。
