Transient Bullous Dermolysis of the Newborn

    November 1985 in “ Archives of Dermatology ”
    Ken Hashimoto
    TLDR The newborn's skin blisters healed without scarring, leaving some light spots, and stopped forming after four months.
    A black male newborn developed large bullae on his extremities and other friction areas shortly after birth, which healed rapidly with hypopigmentation but no scarring. New lesions appeared occasionally for four months but ceased thereafter. At 12 months, the infant was healthy with some residual hypopigmentation. Histologic and electron microscopic examinations showed subepidermal bullae due to subbasal lamina separation, caused by collagenolysis and damage to anchoring fibrils. The perifollicular collagen sheath was damaged, but the periductal collagen of the eccrine duct remained intact. Keratinocytes in the lower epidermis had large, dilated rough endoplasmic reticulum (RER) containing electron-dense stellate bodies, suspected to be proteolytic enzymes responsible for collagenolysis. The severity of collagenolysis correlated with the number and size of RER vacuoles.
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