Hertz K C, Katz S I
Pediatrics. 1977 Jun;59(6):945-8.
Subepidermal blistering diseases of childhood have, in the past, been thought to represent cases of juvenile dermatitis herpetiformis, bullous pemphigoid, or benign chronic bullous dermatosis of childhood. While the small-blister variety closely resembles adult-type dermatitis herpetiformis, the large-blister, or bullous, variety has clinical and histologic resemblances to bullous pemphigoid. The patient presented in this report clearly fits previous descriptions of the large-blister type of juvenile dermatitis herpetiformis, bullous pemphigoid, or benign chronic bullous dermatosis of childhood both clinically and histologically, while his therapeutic response to dapsone and the presence of in vivo bound IgA at the basement membrane of normal and perilesional skin are highly characteristic of the adult type of dermatitis herpetiformis. Immunofluorescent studies of similar cases reported in the literature, however, have shown variable results, thus obscuring their classification. Though the proper place of all such cases in the nosology of blistering diseases is not yet clear, at least some of them closely resemble adult-type dermatitis herpetiformis by two important criteria--immunologic and therapeutic.
过去，儿童的表皮下大疱性疾病被认为是青少年疱疹样皮炎、大疱性类天疱疮或儿童良性慢性大疱性皮肤病的病例。虽然小水疱型与成人型疱疹样皮炎非常相似，但大水疱型（即大疱型）在临床和组织学上与大疱性类天疱疮相似。本报告中呈现的患者在临床和组织学上均明显符合先前对青少年疱疹样皮炎大疱型、大疱性类天疱疮或儿童良性慢性大疱性皮肤病的描述，然而，他对氨苯砜的治疗反应以及在正常皮肤和皮损周围皮肤的基底膜处存在体内结合的IgA是成人型疱疹样皮炎的高度特征。然而，文献中报道的类似病例的免疫荧光研究结果各不相同，因此使其分类变得模糊不清。尽管所有这些病例在大疱性疾病分类学中的恰当位置尚不清楚，但至少其中一些病例通过两个重要标准——免疫学和治疗学——与成人型疱疹样皮炎非常相似。
