Kinder- und Jugendmedizin 2007; 7(05): 266-276
DOI: 10.1055/s-0038-1625675
Dermatologie
Schattauer GmbH

Autoimmunbullöse Dermatosen in der Kindheit

Michael Sticherling
1   Hautklinik, Universitätsklinikum Erlangen (Direktor: Prof. Dr. med. Gerold Schuler)
› Institutsangaben
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Publikationsverlauf

Eingegangen: 15. Mai 2007

angenommen 22. Mai 2007

Publikationsdatum:
10. Januar 2018 (online)

Zusammenfassung

Blasenbildung ist eine typische Reaktion der Haut auf vielfältige exogene und endogene Auslöser und findet sich entweder intraepidermal mit klinisch schlaffen Blasen und im Bereich der Basalmembranzone mit klinisch prallen Blasen. Bullöse Autoimmunerkrankungen sind in der Kindheit und Jugend selten und eher differenzialdiagnostisch bedeutsam. Mangelndes Therapieansprechen oder Rezidivieren einer bullösen Hauterkrankung sollte einen sehr viel häufigeren infektiösen Hintergrund infrage stellen lassen. Aufgrund des klinischen Bildes, histologischer und immunhistologischer wie immunserologischer Untersuchungen lässt sich die Diagnose stellen und eine adäquate Therapie einleiten. Die häufig über längere Zeit nötige immunsuppressive Therapie ist gerade im Kindesalter für die körperliche und seelische Entwicklung der Betroffenen problematisch und verantwortungsvoll. Andererseits ist mit den heute zur Verfügung stehenden Therapeutika die Prognose der Erkrankungen wesentlich besser geworden.

Summary

Bullous lesions represent a basic skin reaction to diverse exogenous as well as endogenous causes. It can be found either intraepidermally resulting in clinically flaccid bullae or at the basement membrane zone resulting in clinically tense bullae. Bullous autoimmune skin diseases are rare in childhood and adolescence and of importance for differential diagnosis. Lacking therapeutic response and recidivating course should question diagnosis of the more common infectious diseases. The clinical picture as well as results of histological, immunohistological and immunoserological examinations allow the exact diagnosis and induction of ample therapy. Long-standing immunosuppressive therapy is often necessary and poses serious problems regarding the physical and mental development of affected children. On the other side, current therapeutic procedures have resulted in a much improved prognosis of this group of diseases.

 
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