Chronic bullous dermatosis of childhood.

A study of 16 patients with chronic bullous dermatosis of childhood (CBDC) is reported. They were followed up for 0.5 to 4.5 years. Histological and immunofluorescent (IF) study of the skin and local provocation of skin lesions by Trafuril test were carried out in every case, intestinal biopsy in twelve cases. Four patients were found to have IgG, and three IgA, along the skin basement membrane. In nine patients, no immunoglobulins were detectable; these IF negative cases seemed to be pseudonegative. Repeated biopsy and immunoelectronmicroscopic study of the skin may be helpful. In the three patient groups classified on the basis of skin IF studies, there was no difference in the clinical and histological picture, in reaction to Trafuril test and in the result of treatment. The small intestinal mucosa was abnormal in three of twelve patients. A gluten-free diet introduced in two patients had no effect on the course of the disease. CBDC with negative or positive IF, juvenile pemphigoid and IgA linear dermatosis seem to be a common clinical entity, different in severity and with individual variations. The condition is not identical with dermatitis herpetiformis Duhring.