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Pemphigus herpetiformis (PH) is characterized by grouped vesicular or papular pruritic lesions with histologic and immunopathologic features of pemphigus. PH can manifest at any age, and paraneoplastic cases have been reported. We describe a healthy boy born with acral crateriform erosions of the hands and feet whose 35-year-old mother had similar lesions. Biopsies from both patients were most consistent with PH. The mother was diagnosed with high-grade B-cell non-Hodgkin lymphoma and began chemotherapy with dexamethasone, and her lesions quickly improved. The infant had no additional lesions after 3 weeks of age and his acral erosions healed. To our knowledge, this is the first report of a diagnosis of PH in an infant and the first case of transplacental transmission of PH. This is also the first report of paraneoplastic PH in lymphoma. This case adds to the growing differential diagnosis of skin disease in postpartum women and their neonates., (© 2015 Wiley Periodicals, Inc.)

Premature and systemically ill infants have a high risk of developing dermatologic infectious complications, displaying the consequences of skin barrier immaturity. Opportunistic infections are an increasing concern in neonates, with cutaneous fungal infections (Aspergillus, Rhizopus, Mucor, Fusarium) observed more commonly as pathogens. Neonates are especially susceptible due to stresses of the perinatal transition to ex-utero life, stratum corneum immaturity, and medical intervention during early life including intravenous catheters, non-sterile adhesive dressings, broad spectrum antibiotic use, and systemic corticosteroids for lung disease. Cutaneous presentations of these infections encompass a broad set of morphologies: papules, vesicles, pustules, ecchymoses, and necrotic, pupuric plaques. There are many etiologies that present as ecchymoses and scaly or crusted lesions. The presentation, diagnosis, and treatment options in the neonatal patient presenting with ecchymoses and crusts will be discussed., (© 2011 Wiley Periodicals, Inc.)