Childhood bullous pemphigoid following hepatitis B
immunization.
Erbagci Z.
Gaziantep University Medical Faculty, Department of Dermatology, Gaziantep,
Turkey.
Bullous pemphigoid (BP) is an acquired autoimmune bullous disorder which
predominantly affects the elderly. It is very rare in children. There are
approximately 50 reported cases of childhood BP. Although the cause of
childhood BP is unknown, drug intake and vaccination have been incriminated in
some cases. A total of 13 patients with BP (10 adults and 3 infants) have been
described to be related to various vaccines and tetanus toxoid booster.
However, no case related to hepatitis B vaccination has previously been
reported. Our case of childhood BP developed one week after hepatitis B
immunization in a Turkish caucasian child. This case suggests that the
hepatitis B surface antigen can function as the triggering factor for BP by
inducing a nonspecific immune reactivation which unmasks subclinical BP or by
stimulating a specific antibody production that may cross-react with BP
antigens.
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