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Neonatal Autoimmune Blistering Disease: A Systematic Review
Author(s) -
Zhao Cathy Y.,
Chiang Yi Zhen,
Murrell Dedee F.
Publication year - 2016
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12859
Subject(s) - medicine , bullous pemphigoid , pemphigus , pemphigus vulgaris , pemphigoid , dermatology , epidermolysis bullosa acquisita , autoantibody , autoimmune disease , pemphigus foliaceus , hydroxychloroquine , disease , immunology , antibody , covid-19 , infectious disease (medical specialty)
We aimed to better understand the pathogenesis, clinical features, prognosis, and treatment of neonatal autoimmune blistering diseases ( AIBD s). We searched Medline, Embase, PubMed, Latin American and Caribbean Health Sciences Literature, and reference lists of identified articles. Inclusion criteria were articles published from 1946 to December 2014 in any language. Exclusion criteria were age greater than 4 weeks and no confirmed AIBD diagnosis. We identified 51 cases of neonatal AIBD s: 34 cases of pemphigus (31 pemphigus vulgaris [ PV ], 3 pemphigus foliaceus [ PF ]) and 17 cases of pemphigoid diseases (9 bullous pemphigoid [ BP ], 5 linear immunoglobulin A bullous dermatosis [ LABD ], 1 BP and LABD , 1 epidermolysis bullosa acquisita, 1 bullous systemic lupus erythematosus). Pemphigoid diseases had a higher male predominance (male:female ratio 4.6:1) than pemphigus (male:female ratio 1:1.06) (p = 0.004). Pemphigus had a higher proportion presenting at birth (79.4%) than pemphigoid diseases (29.4%) (p = 0.008). The most common sites involved were the trunk (63.0%), followed by the head and neck (60.9%). The mucosal membranes were involved in 32.6% of cases (27.6% in pemphigus, 41.6% in pemphigoid diseases). Only 33.3% used systemic therapy, and 75.5% achieved control within 3 weeks. Most PV , PF , and BP cases, but not LABD s, reported maternal disease. In pemphigus cases, 75.0% of mothers had active disease and 25.0% were in control. Pregnant women with PV , PF , and PG of any severity can passively transfer autoantibodies leading to neonatal AIBD . Pemphigoid diseases are more likely to present after birth and may be more male predominant. The presentation of LABD s may be different from that of all other AIBD s.