Hydroa Vacciniforme: A Rare Pediatric Photodermatosis

Hydroa vacciniforme (HV) is a rare, chronic photodermatosis linked to Epstein-Barr virus (EBV) infection. We report a 12-year-old child with recurrent vesiculobullous facial lesions and photosensitivity for six years. Clinical examination revealed hemorrhagic crusts with atrophic scars. Dermoscopy showed whitish streaks and rosettes. Histopathology demonstrated epidermal spongiosis and a dense dermal lymphoid infiltrate. Immunohistochemistry confirmed CD3+, CD5+, CD7+, and CD8+ lymphocytes, with granzyme B and perforin expression, but no CD56. EBV serology was positive. Differential diagnoses, including cutaneous lupus, leishmaniasis, and porphyria, were excluded. The patient was managed with strict photoprotection, leading to sustained remission over two years. Early diagnosis and sun protection are essential for managing HV, as seen in our case.