My 16-year-old boy developed blistering skin lesions after having MenB vaccination. Why?

Hi,

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Thank you for allowing me to treat your skin problem. Thank you also for providing information. Kindly hold on a minute; I am typing a detailed answer and explanation of your query. The clinical picture you have sent (attachment removed to protect patient identity) looks like a ring of blisters, possible in linear IgA dermatosis, bullous pemphigoid, and impetigo. Can you send other site pictures of blisters (skin and mucosal)? Is there itching? Do you have any biopsy report? Where is the site of pain exactly? Any details about cyst? Any other blood reports? Since how many days is he on Dapsone and Prednisolone? If you are unable to provide the above information, then from available data, I can conclude, Vaccination-induced linear IgA dermatoses or also bullous pemphigoid is possible. If you have done a biopsy, then for more confirmation, you can go for an immunofluorescence study. Treatment of it requires according to patient response, and with proper treatment, it can subside. If MRSA (Methicillin - resistant staphylococcus aureus) infected wound there, then you can go with culture and sensitivity for treatment. Linezolid or Vancomycin are good options. For pain, for the time being, you can give tablet Aceclofenac and Paracetamol half tablet morning and night after food for five days with tablet Omeprazole 20 mg morning before food for five days. Otherwise, go for an injectable analgesic. Thank you.

Hi,

Welcome back to icliniq.com.

Thank you for providing information and photographs (attachment removed to protect patient identity). Linear IgA bullous dermatosis is a kind of autoimmune blistering skin disease, in which some antibodies (IgA) formed against some skin antigens (skin components). The subsidence depends on the severity of blisters, area of involvement, treatment, and person’s body response. Most causes are some medicines (drugs), post-vaccination, non-specific antigens stimuli or idiopathic, etc. Yes, sometimes, it is resistant to regular treatment. If he is on Dapsone for a period and his blisters are still appearing and persisting, then treatment options are Dapsone (low dose) with Mycophenolate Mofetil. Other options are Azathioprine, Cyclosporin, or Colchicine, but it is according to the risk-benefit ratio. Another option is Corticosteroid (with Azathioprine or Mycophenolate mofetil) pulse therapy. But all these treatments require monitoring. So it should be done under the supervision of a dermatologist or done in a hospital after his admission, with the required antibiotics. It will subside with proper treatment and monitoring and with maintenance treatment. Thank you.