Australasian Journal of Dermatology最新文献

{"title":"Tuberculosis reactivation following apremilast therapy for psoriasis: Time to consider routine TB screening?","authors":"Lucinda Adams,&nbsp;Emma L. Smith FRACP MBChB MSc DTM&H,&nbsp;Dev Tilakaratne,&nbsp;Vicki Krause","doi":"10.1111/ajd.14364","DOIUrl":"10.1111/ajd.14364","url":null,"abstract":"<p>Apremilast is a relatively new oral treatment for psoriasis, which reduces expression of pro-inflammatory factors, including tumour necrosis factor-α (TNFα), critical to the immune control of <i>Mycobacterium tuberculosis</i> infection. In randomised controlled trials (RCTs) for apremilast no new cases of active tuberculosis (TB) were identified, thus, screening for latent TB infection (LTBI) is not currently recommended prior to apremilast initiation. We describe a case of <i>M.tuberculosis</i> reactivation shortly after commencement of apremilast for psoriasis. We are recommending clinicians perform LTBI risk assessment in all patients, and appropriate LTBI screening in select populations prior to apremilast initiation.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"e255-e258"},"PeriodicalIF":2.2,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142226885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of oral benzodiazepines for patient anxiety associated with Mohs micrographic surgery: An Australian survey","authors":"Adam G. Harris MBCHB, MMED, FACD,&nbsp;Simon Lee MBBS, MM (Med), FACD","doi":"10.1111/ajd.14361","DOIUrl":"10.1111/ajd.14361","url":null,"abstract":"<p>A survey of Mohs surgery specialists in Australia showed diazepam was the preferred agent and felt to be the safest oral benzodiazepine for perioperative anxiolysis.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"652-653"},"PeriodicalIF":2.2,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142215707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Skin health of Aboriginal children living in urban communities","authors":"Bernadette M. Ricciardo MBBS, DCH, FACD,&nbsp;Heather-Lynn Kessaris BSc, MD,&nbsp;Noel Nannup OAM,&nbsp;Dale Tilbrook GradDipBus,&nbsp;Nadia Rind,&nbsp;Richelle Douglas MBBS, FRACGP,&nbsp;Jodie Ingrey BSc, RN,&nbsp;Jacinta Walton,&nbsp;Carol Michie,&nbsp;Brad Farrant BSc, PhD,&nbsp;Eloise Delaney BBiomedSc,&nbsp;S. Prasad Kumarasinghe MBBS, MD, FACD,&nbsp;Jonathan R. Carapetis MBBS, FRACP, PhD,&nbsp;Asha C. Bowen MBBS, DCH, FRACP, PhD","doi":"10.1111/ajd.14363","DOIUrl":"10.1111/ajd.14363","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Skin concerns are frequent among urban-living Aboriginal children, yet specialist dermatology consultations are limited with studies highlighting the need for improved cultural security. Through newly established paediatric dermatology clinics at two urban Aboriginal Community Controlled Health Organisations (ACCHOs), we aimed to describe clinic and patient data, including disease frequencies and associations, to inform dermatology service provision and advocacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective cohort study of Aboriginal children and young people (CYP, 0–18 years) attending Aboriginal Health Practitioner (AHP) co-ordinated paediatric dermatology clinics at two urban ACCHOs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data were collected from 32 clinics over 19 months, with 335 episodes of care and a mean attendance rate of 74%. From 78 new patients, 72 (92%) were recruited into the study, only one of whom had previously received dermatologist assessment. Eczema, tinea or acne accounted for 47% (34/72) of referrals, and 60% of patients received their first appointment within 4 weeks of referral. In 47/72 (65%) consultations, the GP referral and dermatologist diagnosis concurred. The most frequent diagnoses (primary or secondary) at first consultation were atopic dermatitis (26%, 19/72), dermatophyte infections (25%, 18/72), acne (21%, 15/72), bacterial skin infections (18%, 13/72) and post-inflammatory dyspigmentation (18%, 13/72). Three categories of the 2022 Australasian College of Dermatologists curriculum (infections, eczema/dermatitis, pigmentary disorders) accounted for 59% of all diagnoses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the specialist dermatology needs of urban-living Aboriginal CYP. ACCHO-embedded dermatology clinics co-ordinated by AHPs demonstrated benefits for Aboriginal CYP in accessing care. Opportunities to embed dermatology practice within ACCHOs should be prioritised.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"e224-e237"},"PeriodicalIF":2.2,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The risk of psychiatric disorders in finasteride users with benign prostatic hyperplasia and androgenetic alopecia: A population-based case–control study","authors":"Anna Lyakhovitsky MD,&nbsp;Boaz Amichai,&nbsp;Eran Galili MD,&nbsp;Arnon Cohen,&nbsp;Khalaf Kridin,&nbsp;Zvi Segal,&nbsp;Doron Netzer","doi":"10.1111/ajd.14359","DOIUrl":"10.1111/ajd.14359","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is a long-standing debate if finasteride, a medication used to treat benign prostatic hyperplasia (BPH) and androgenetic alopecia (AGA), can cause psychiatric side effects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The goal of this large-scale population-based study was to determine whether finasteride therapy for BPH and AGA is associated with the emergence of mental health conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational case–control study compared the data from patients with BPH who received finasteride 5 mg daily and patients with AGA who received finasteride 1 mg daily with age- and gender-matched controls. The incidence of psychological health outcomes such as depression, anxiety, neuroses, bipolar disorder, schizophrenia, psychoses and alcohol abuse within 2 years of the initiation of finasteride therapy has been evaluated and compared between the finasteride groups and controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The BPH group included 307 men with a mean age of 61.5 (±17.4) years and 1218 controls. Mental health outcomes recorded in 2.3% of the patients, with no significant increase in rate when compared to controls. The AGA group consisted of 23,227 men with a mean age of 31.4 (±10.3) years and 39,444 controls. One percent of AGA patients developed psychiatric disorders. In comparison to controls, patients with AGA had higher rates of anxiety and depression (0.6% vs. 0.4%, <i>p</i> = 0.04, and 0.5% vs. 0.4%, <i>p</i> = 0.007, respectively). In multivariate regression models, finasteride was found as one of the risk factors for anxiety (OR 1.449, <i>p</i> = 0.002) and depression (OR 1.439, <i>p</i> = 0.003) when stratified to age, sector, socioeconomic status and comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>According to our research, finasteride users had a very low rate of adverse mental health effects, with no increase in psychological sequelae in BPH patients and a slight increase in anxiety and depression in AGA patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"621-629"},"PeriodicalIF":2.2,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141974969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dermatological care of gender-diverse patients in Australia","authors":"Roy Kingsley Wong MBBS,&nbsp;Jenny Harrington PhD,&nbsp;Annabel Irene Stevenson MBBS, MMed, FACD","doi":"10.1111/ajd.14360","DOIUrl":"10.1111/ajd.14360","url":null,"abstract":"<p>In recent years, there has been an increasing recognition of the unique healthcare needs of gender-diverse patients in Australia. With the continuous growth of referrals to gender health services, there is an increased demand for specialised dermatological care. There is still a significant knowledge gap and a lack of guidelines specifically tailored to this patient group. In this article, we will provide a brief overview of the journey of Transgender and Gender Diverse (TGD) individuals as they embark on psychological and pharmacologic treatment for gender dysphoria in Australia. We endeavour to contribute to the existing body of knowledge by examining the evidence surrounding the treatment of skin, hair and nail issues for TGD patients. This article will outline how dermatologists can assist in the care of the gender-diverse patient. Although puberty blockade (stage 1 treatments) has minimal dermatological impact, gender-affirming pharmacotherapy (stage 2 treatments) can lead to many dermatological issues including acne, patterned hair loss (PHL) and dermatitis. The dermatologist may also play a role in stage 3 treatments which include surgical or procedural interventions for gender affirmation.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"601-609"},"PeriodicalIF":2.2,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of biologic drugs in children or adolescents with atopic dermatitis: A systematic review and meta-analysis of randomized controlled trials","authors":"Ana Clara Felix de Farias Santos,&nbsp;Fernanda Valeriano Zamora MD,&nbsp;Lorhayne Kerly Capuchinho Scalioni Galvao MD,&nbsp;Nicole dos Santos Pimenta,&nbsp;João Pedro Costa Esteves Almuinha Salles,&nbsp;Kélen Klein Heffel MD","doi":"10.1111/ajd.14358","DOIUrl":"10.1111/ajd.14358","url":null,"abstract":"<p>Children and adolescents suffering from moderate-to-severe atopic dermatitis (AD) face a significant disease burden that greatly impacts their quality of life. Treatment options for AD are currently limited. To assess the safety and efficacy of biologic drugs, dupilumab, lebrikizumab, or tralokinumab, in improving outcomes in patients with moderate to severe inadequately controlled AD. We searched PubMed, Embase and Cochrane databases for randomized controlled trials (RCTs) comparing dupilumab, lebrikizumab or tralokinumab to placebo in patients with AD. We computed odds ratios (ORs) for binary endpoints, with 95% confidence intervals (CIs), random effects model was used and a <i>p</i>-value &lt;0.05 was considered as statistically significant. We analysed data into Review Manager 5.4. A total of five RCTs and 973 patients were included, of whom 592 were prescribed a biologic drug. Compared with placebo, patients receiving a biologic drug had a greater improvement, achieved an Investigator Global Assessment (IGA) score of 0 or 1 (OR 5.05; 95% CI 3.08–8.29), Eczema Area and Severity Index (EASI) 75 (OR 6.87; 95% CI 4.71–10.02), EASI 50 (OR 8.89; 95% CI 6.18–12.78) and EASI 90 (8.30; 95% CI 4.81–14.31). The proportion of patients with 3 points or more (OR 6.56; 95% CI 4.34–9.90) or 4 points or more (OR 8.09; 95% CI 5.19–12.59) improvement from baseline in peak pruritus NRS was significantly higher with biologic drugs than placebo. There were no significant differences between groups regarding adverse events (OR 0.79; 95% CI 0.58–1.07), and conjunctivitis (OR 2.08; 95% CI 1.00–4.33). In this meta-analysis, dupilumab, lebrikizumab, and tralokinumab have shown significant improvements in signs, symptoms and quality of life in children or adolescents with moderate to severe AD. Larger studies may be needed to continue evaluating the safety and efficacy of these biologic drugs in this patient population.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"550-559"},"PeriodicalIF":2.2,"publicationDate":"2024-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biologic treatment outcomes in generalized pustular psoriasis of pregnancy: A systematic review","authors":"YuFei Wang BM,&nbsp;ChaoJing Zhou BM,&nbsp;YiYun Hou BM,&nbsp;YaMei Gao MM,&nbsp;JiLiang Lu MM,&nbsp;ZhiQiang Yin MD, PhD","doi":"10.1111/ajd.14357","DOIUrl":"10.1111/ajd.14357","url":null,"abstract":"","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 8","pages":"650-651"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A narrative review of the literature: The role of biologics and JAK inhibitors in vitiligo","authors":"Rhiannon Russell MD,&nbsp;Benjamin S. Daniel MBBS","doi":"10.1111/ajd.14353","DOIUrl":"10.1111/ajd.14353","url":null,"abstract":"<p>Vitiligo is a chronic depigmenting disorder that significantly impacts the quality of life of patients. Though there have been significant advancements in targeted therapies in skin diseases such as psoriasis or eczema, the progress in the treatment of vitiligo has been slow, with minimal studies assessing the effect of biologics, though there has been recent evidence of the effectiveness of JAK inhibition. This paper reviews the published case reports and studies for the use of systemic targeted therapies including biologics and JAK inhibitors in vitiligo.</p>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"539-549"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The cardiovascular risk in bullous pemphigoid: Insights from a population-based study","authors":"Khalaf Kridin PhD,&nbsp;Rina Goychberg BSc,&nbsp;Mouhammad Kridin MD,&nbsp;Niv Kafri BSc,&nbsp;Masad Barhoum MHA,&nbsp;Arnon D. Cohen PhD","doi":"10.1111/ajd.14355","DOIUrl":"10.1111/ajd.14355","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The risk of life-threatening major cardiovascular outcomes among patients with bullous pemphigoid (BP) is inconsistent in the current literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the risk and prognostic outcomes of myocardial infarction (MI), cerebrovascular accident (CVA), peripheral vascular disease (PVD) and pulmonary embolism (PE) in patients with BP. We additionally aimed to explore the influence of different therapeutic approaches on the risk of these outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A population-based retrospective cohort study was conducted to compare BP patients (<i>n</i> = 3924) with age-, gender- and ethnicity-matched control subjects (<i>n</i> = 19,280) with regard to incident cases of MI, CVA, PVD and PE. Adjusted hazard ratio (HR) and 95% confidence intervals (CI) were estimated by multivariate Cox regression analysis. Data were retrieved from Clalit Health Services' computerized database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Relative to their matched controls, patients with BP were at an elevated risk of MI (fully-adjusted HR: 1.44; 95% CI: 1.14–1.81; <i>p</i> = 0.002), CVA (fully-adjusted HR: 1.24; 95% CI: 1.06–1.45; <i>p</i> = 0.007), PVD (fully-adjusted HR: 1.60; 95% CI: 1.27–2.03; <i>p</i> = 0.003) and PE (fully-adjusted HR: 1.72; 95% CI: 1.28–2.32; <i>p</i> &lt; 0.008). Patients with BP experienced heightened risk of all-cause mortality in the presence of comorbid MI (fully-adjusted HR: 1.61; 95% CI: 1.44–1.81; <i>p</i> &lt; 0.001), CVA (fully-adjusted HR: 1.70; 95% CI: 1.52–1.89; <i>p</i> &lt; 0.001), PVD (fully-adjusted HR: 1.38; 95% CI: 1.20–1.58; <i>p</i> &lt; 0.001) and PE (fully-adjusted HR: 1.44; 95% CI: 1.10–1.88; <i>p</i> = 0.007). The therapeutic approach utilized to manage BP did not significantly influence the risk of cardiovascular outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>BP is associated with an elevated risk of MI, CVA, PVD, PE and cardiovascular mortality. Primary, secondary and tertiary cardiovascular prevention measures should be implemented among patients with BP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e187-e193"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bullous pemphigoid in infancy","authors":"Lois Zhang BMed, MMed,&nbsp;Gloria Fong BMLSc, MBBS, PhD, FACD,&nbsp;Andrew Ming BSC(MED), MBBS(HONS), DCH, FRACP, FACD,&nbsp;Melanie Wong MBBS(Hons), PhD, FRACP, FRCPA","doi":"10.1111/ajd.14354","DOIUrl":"10.1111/ajd.14354","url":null,"abstract":"&lt;p&gt;Bullous pemphigoid (BP) is an autoimmune, subepidermal blistering disease typically affecting the elderly and remains rare in children and infants. Paediatric BP often presents with mucosal involvement, and in infants, commonly affects the hands and feet. The pathogenesis is thought to be similar to that of adult BP with autoantibodies to BP180 (type VII collagen) having been described in the literature. Here, we present a case of BP occurring in a 2-month-old, investigating the potential role of vertical transmission of autoantibodies.&lt;/p&gt;&lt;p&gt;A 2-month-old female infant presented with blistering eruptions initially localised to the hands and feet, which rapidly extended to the groin, neck, arms, and chest. The antenatal and birth history were unremarkable, and there was no family history of autoimmune diseases. The infant was systemically well. Physical examination revealed tense and flaccid bullae on the hands and feet, deep-seated vesicles on an erythematous base on the torso, and some erosions (Figure 1). Mucosal surfaces were unaffected. Viral and bacterial swabs were negative. Histopathology of skin biopsies showed eosinophilic spongiosis and subepidermal bulla formation, with indirect immunofluorescence demonstrating linear C3 and IgG deposition at the dermal-epidermal junction. Serum indirect immunofluorescence was positive for BP180 antibodies, confirming the diagnosis of BP. The infant was treated with high-potency topical corticosteroids (0.05% betamethasone dipropionate) and a short course of oral antibiotics. Significant improvement and complete resolution of the lesions were observed by 6 months of age, with no relapse. The mother had no history of BP or pemphigoid gestationis and no peripartum skin lesions. However, serum indirect immunofluorescence testing of the mother revealed the presence of BP230 antibodies. Six months later, repeat testing showed the absence of antibodies in both mother and child.&lt;/p&gt;&lt;p&gt;The exact cause of BP remains unclear, although certain triggers have been identified such as drug-induced BP and infections.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; A potential trigger in neonates and infants may include the transplacental transfer of antibodies, a known mechanism that forms the foundation for maternal immunisation strategies where antibodies may be present up to 6–12 months from birth.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; Transfer of pathogenic antibodies has been seen to cause transient disease in infants from asymptomatic mothers such as in neonatal lupus and thyroid disease. In neonatal BP, BP180 antibodies are recognised as the pathogenic cause of the neonatal onset of disease.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;We postulate that our patient's mother developed low levels of BP180 as well as BP230 antibodies, during pregnancy, with active transplacental transfer of BP180 antibodies, leading to levels capable of inducing clinical disease in her baby. Due to the half-life of IgG antibodies (21 days), by the time of testing, mater","PeriodicalId":8638,"journal":{"name":"Australasian Journal of Dermatology","volume":"65 7","pages":"e219-e220"},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajd.14354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141858852","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}