Large Blisters on Baby Infant

[mikefusion]

My three week old niece was admitted to the children’s hospital with some large blisters on her hands.  So far, she’s had no fever, her white blood cell count is normal, and all bacterial cultures and spinal taps have been negative.  We have the pediatric staff stumped.  She had a couple small blisters (pimple-size) form on her hands and feet about three days ago.  Several grew to pencil-eraser size and burst.  One on her index finger grew much larger and threatened to cover her entire finger.  She has a few other tiny spots on her arms and legs, and several other small blisters on her feet.  The blisters look like second-degree burns, mostly clear fluid inside, though some did contain a bloody mix.    She’s presently on two antibiotics and an antiviral as a precaution.  Anybody seen anything like this before?

Photos of her fingers are available here.  The finger is coated with ointment.

http://www.hoganconsulting.com/finger1.jpg
http://www.hoganconsulting.com/finger2.jpg

[BhumikaMD]

Hi,

'Blisters are usually caused by injury to the skin from heat or from friction, which create a tear between the epidermis—the upper layer of the skin—and the layers beneath. When this happens, the surface of the skin remains intact, but is pushed outwards as serum seeps into the newly created space between the layers.

Short periods of intense rubbing can cause a blister, but any rubbing of the skin at all can cause a blister if it is continued for long enough. Blisters are most common on the hands and feet, as these extremities are susceptible while walking, running, or performing repetitive motions. Blisters form more easily on moist skin than on dry or soaked skin, and are more common in warm conditions.

Sometimes, the skin can blister when it comes into contact with a cosmetic, detergent, solvent or other chemical; this is known as contact dermatitis. Blisters can also develop as a result of an allergic reaction to an insect bite or sting.'

http://en.wikipedia.org/wiki/Blister

Most blisters heal naturally and do not require medical attention. As new skin grows beneath the blister, the fluid contained within it will be slowly reabsorbed by the body and the skin on top will dry and peel off.

The unbroken skin over a blister provides a natural barrier to infection. This means that you should try to keep blisters intact and unbroken in order to avoid infection. Try not to pierce a blister with a needle, but allow it to break on its own once the skin underneath has healed.

Let us know if you need any further information.

Regards.

[mikefusion]

The final diagnosis was "Epidermolysis Bullosa" confirmed by multiple skin biopsies of blistered areas.  The parents are awaiting genetic testing to confirm if they are recessive carriers..