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Question:
Pavitra Viswanathan, Sahana Devadas
Department of Pediatrics, Bangalore Medical College and Research Institute, Bangalore, India.

Address for correspondence: Dr Pavitra Viswanathan, S1, Pinewood Golflinks, S.R.layout, Murugeshpalya, Bangalore-560001, India. Email: drpavitraviswanathan@gmail.com

A 5 days old female child, first born out of non-consanguineous marriage presented with blisters in the dorsum of the foot since birth which was surrounded by red skin (Figure 1). Antenatal period was uneventful and the baby was born by vaginal delivery and had a birth weight of 2.5kg. The blisters broke down by day 7 of life and became rough textured which later changed to dark lines in the same areas which was occupied by earlier lesions (Figure 2). There was no peeling of skin or fever, refusal of feeds, lethargy or other complaints. Initial impression of the baby at presentation was that of a vesiculobullous disorder-probably herpetic blisters. There was no maternal history to support this diagnosis and Tzanck smear was negative for giant cells. Sepsis workup was normal with cultures being negative. Skin biopsy showed a picture of spongiotic dermatosis. In ophthalmic evaluation the right eye showed retinal hemorrhages and in left eye retinal hemorrhage, infarct and dilated shunt vessels were found. Cranial ultrasound was normal.

What is the diagnosis_?

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