{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:04:03Z","timestamp":1760234643528,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,6,4]],"date-time":"2021-06-04T00:00:00Z","timestamp":1622764800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dermatopathology"],"abstract":"<jats:p>The onset of blisters in a neonate or an infant is often a source of great concern for both parents and physicians. A blistering rash can reveal a wide range of diseases with various backgrounds (infectious, genetic, autoimmune, drug-related, traumatic, etc.), so the challenge for the dermatologist and the pediatrician is to quickly determine the etiology, between benign causes and life-threatening disorders, for a better management of the patient. Clinical presentation can provide orientation for the diagnosis, but skin biopsy is often necessary in determining the cause of blister formations. In this article, we will provide information on the skin biopsy technique and discuss the clinical orientation in the case of a neonate or infant with a blistering eruption, with a focus on the histology for each etiology.<\/jats:p>","DOI":"10.3390\/dermatopathology8020022","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T22:23:00Z","timestamp":1623104580000},"page":"159-175","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["How to Deal with Skin Biopsy in an Infant with Blisters?"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2468-3910","authenticated-orcid":false,"given":"St\u00e9phanie","family":"Leclerc-Mercier","sequence":"first","affiliation":[{"name":"Reference Center for Genodermatoses (MAGEC Center), Department of Pathology, Necker-Enfants Malades Hospital, Paris Centre University, 75015 Paris, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1073","DOI":"10.1001\/archderm.143.8.1074","article-title":"Histologic cutaneous modifications after the use of EMLA cream, a diagnostic pitfall: Review of 13 cases","volume":"143","author":"Cazes","year":"2007","journal-title":"Arch. Dermatol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1111\/pde.14470","article-title":"Staphylococcal scalded skin syndrome: An epidemiological and clinical review of 84 cases","volume":"38","author":"Pope","year":"2021","journal-title":"Pediatr. Dermatol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1433","DOI":"10.1001\/archderm.1975.01630230035004","article-title":"Toxic epidermal necrolysis. Rapid differentiation between staphylococcal and drug induced disease","volume":"111","author":"Amon","year":"1975","journal-title":"Arch. Dermatol."},{"key":"ref_4","first-page":"134","article-title":"Vesiculopustular, bullous and erosive diseases of the neonate","volume":"1","author":"Hoeger","year":"2019","journal-title":"Harper\u2019s Textbook of Pediatric Dermatology"},{"key":"ref_5","first-page":"858","article-title":"Infectious diseases of the skin","volume":"1","author":"Calonje","year":"2019","journal-title":"McKee\u2019s Pathology of the Skin"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"614","DOI":"10.1111\/bjd.18921","article-title":"Consensus reclassification of inherited epidermolysis bullosa and other disorders with skin fragility","volume":"183","author":"Has","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1103","DOI":"10.1016\/j.jaad.2014.01.903","article-title":"Inherited epidermolysis bullosa: Updated recommendations on diagnosis and classification","volume":"70","author":"Fine","year":"2014","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1111\/bjd.18128","article-title":"Clinical practice guidelines for laboratory diagnosis of epidermolysis bullosa","volume":"182","author":"Has","year":"2019","journal-title":"Br. J. Dermatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1016\/j.jaad.2009.11.020","article-title":"Revised nomenclature and classification of inherited ichthyoses: Results of the First Ichthyosis Consensus Conference in Sor\u00e8ze 2009","volume":"63","author":"Oji","year":"2010","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1016\/j.jaad.2008.02.031","article-title":"Histopathologic characterization of epidermolytic hyperkeratosis: A systematic review of histology from the National Registry for Ichthyosis and Related Skin Disorders","volume":"59","author":"Ross","year":"2008","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_11","first-page":"63","article-title":"Disorders of keratinization","volume":"1","author":"Calonje","year":"2019","journal-title":"McKee\u2019s Pathology of the Skin"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1097\/DAD.0b013e3181614898","article-title":"A unique pattern of dyskeratosis characterizes epidermolytic hyperkeratosis and epidermolytic palmoplantar keratoderma","volume":"30","author":"Bergman","year":"2008","journal-title":"Am. J. Dermatopathol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1111\/cup.12680","article-title":"Use of the frozen section \u2018jelly-roll\u2019 technique to aid in the diagnosis of bullous congenital ichthyosiform erythroderma (epidermolytic hyperkeratosis)","volume":"43","author":"Galler","year":"2016","journal-title":"J. Cutan. Pathol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/1523-1747.ep12394307","article-title":"Ichthyosis bullosa of Siemens\u2013A disease involving keratin 2e","volume":"103","author":"McLean","year":"1994","journal-title":"J. Investig. Dermatol."},{"key":"ref_15","first-page":"1163","article-title":"Clinical study of 40 cases of incontinentia pigmenti","volume":"139","author":"Froidevaux","year":"2003","journal-title":"Arch. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1111\/jdv.16403","article-title":"Multidisciplinary consensus recommendations from a European network for the diagnosis and practical management of patients with incontinentia pigmenti","volume":"34","author":"Bodemer","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1111\/j.1600-0560.2009.01206.x","article-title":"Skin biopsy is helpful for the diagnosis of incontinentia pigmenti at late stage (IV): A series of 26 cutaneous biopsies","volume":"36","author":"Fraitag","year":"2009","journal-title":"J. Cutan. Pathol."},{"key":"ref_18","first-page":"1097","article-title":"Paediatric mastocytosis","volume":"Volume 1","author":"Hoeger","year":"2019","journal-title":"Harper\u2019s Textbook of Pediatric Dermatology"},{"key":"ref_19","first-page":"1515","article-title":"Cutaneous lymphoproliferative diseases and related disorders (mastocytosis)","volume":"Volume 2","author":"Calonje","year":"2019","journal-title":"McKee\u2019s Pathology of the Skin"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1001\/jamadermatol.2019.4038","article-title":"Recurrent blistering in an infant","volume":"156","author":"Kamat","year":"2020","journal-title":"JAMA Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/pbc.25834","article-title":"Diverse cutaneous presentations of langerhans cell histiocytosis in children: A retrospective cohort study","volume":"63","author":"Morren","year":"2016","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e500","DOI":"10.1016\/S1470-2045(18)30334-6","article-title":"Blistering Langerhans cell histiocytosis","volume":"19","author":"Chan","year":"2018","journal-title":"Lancet Oncol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2672","DOI":"10.1182\/blood-2016-01-690636","article-title":"Revised classification of histiocytoses and neoplasms of the macrophage-dendritic cell lineages","volume":"127","author":"Emile","year":"2016","journal-title":"Blood"},{"key":"ref_24","first-page":"1071","article-title":"Langerhans Cell Histiocytosis","volume":"Volume 1","author":"Hoeger","year":"2019","journal-title":"Harper\u2019s Textbook of Pediatric Dermatology"},{"key":"ref_25","first-page":"868","article-title":"Differential diagnosis of vesiculobullous lesions","volume":"Volume 1","author":"Hoeger","year":"2019","journal-title":"Harper\u2019s Textbook of Pediatric Dermatology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1111\/jdv.15456","article-title":"Long-term evolving profile of childhood autoimmune blistering diseases: Retrospective study on 38 children","volume":"33","author":"Bekel","year":"2019","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"644","DOI":"10.1016\/j.clindermatol.2015.09.007","article-title":"Bullous diseases: Kids are not just little people","volume":"33","author":"Marathe","year":"2015","journal-title":"Clin. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/pde.12859","article-title":"Neonatal autoimmune blistering disease: A systematic review","volume":"33","author":"Zhao","year":"2016","journal-title":"Pediatr. Dermatol."}],"container-title":["Dermatopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2296-3529\/8\/2\/22\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:10:53Z","timestamp":1760163053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2296-3529\/8\/2\/22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,4]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["dermatopathology8020022"],"URL":"https:\/\/doi.org\/10.3390\/dermatopathology8020022","relation":{},"ISSN":["2296-3529"],"issn-type":[{"type":"electronic","value":"2296-3529"}],"subject":[],"published":{"date-parts":[[2021,6,4]]}}}