CONCLUSION
In our case, the final diagnosis was a paraviral bullous skin eruption
following a primary EBV infection.
In fact, the temporal association with an acute viraemic EBV infection
and the progressive improvement of skin lesions with the resolution of
the viraemia supported the hypothesis of a paraviral skin eruption.
On the other hand, the negativity of the direct immunofluorescence
assay, the self-limiting course and the excellent response to small
doses of systemic steroid did not support the hypothesis of an
autoimmune bullous disease.
Further studies are needed in order to elucidate the association between
EBV-infection and bullous eruption.
In clinical practice, in case of an acute skin bullous eruption the
possible etiology of EBV-infection should be considered, also in
pediatric age.