Presentation
The third biopsy was sent to the present institution. [ijpd.in]
A case of pretibial epidermolysis bullosa is presented and the literature is reviewed. [ncbi.nlm.nih.gov]
DEB Subtypes Features Dominant generalised DEB Generalised blistering present at birth Blistering becomes localised to hands, feet, elbow or knees as the child grows older and in response to friction Small white spots called milia are often present at [dermnetnz.org]
Entire Body System
- Nail Abnormality
The LOC syndrome is characterized by localized blistering and scarring, particularly on the face and neck, in association with upper airway disease activity and nail abnormalities [ 8, 9 ]. [ojrd.biomedcentral.com]
Skin
- Papule
The histology of the lichenoid papules showed amyloid deposition in the papillary dermis. [ncbi.nlm.nih.gov]
A 12-year-old female with low intelligent quotient presented with intensely pruritic multiple violaceous papules which were coalescent at areas on both the shins. Histopathological examination showed epidermis displaying focal thinning. [ijpd.in]
- Pruritus
The intense pruritus contributes to the formation of lesions. [ncbi.nlm.nih.gov]
UVB phototherapy tried in one patient had worsened generalized pruritus 2. [ispub.com]
Symptoms List: Pretibial dystrophic epidermolysis bullosa Symptoms and clinical features may include: 2 Clinical Features of Pretibial dystrophic epidermolysis bullosa : Atypical scarring of skin Pruritus Milia Dystrophic toenail Dystrophic fingernails [familydiagnosis.com]
Bradykinin possibly interacting with other mediators might be responsible for the severe pruritus. [e-ijd.org]
Some patients complain of pruritus. Healing of blisters is associated with hypertrophic scarring and milia formation. Dystrophy of both fingernails and toenails is characteristic. [orpha.net]
- Eruptions
The patient was a 40-year-old Japanese woman who presented a blistering eruption in the pretibial area with flat violaceous-brown lichenoid papules. [ncbi.nlm.nih.gov]
Caused by Protozoa 204 Zoonoses 211 RatBite Fever 216 Dermatomycoses 219 Diagnosis of Mycoses 222 Onychomycosis 236 Systemic Mycoses 244 Epizoonoses 248 Cimicosis 251 Ticks 260 Diseases Caused by Worms 262 Annelida Ringlet or Bristle Worms 270 Drug Eruptions [books.google.de]
Mild pretibial bullous eruptions com-menced at the age of 11 years, associated withpruritus, and resolved leaving hypertrophic localizedscarring. [documents.tips]
• Teeth show severe enamel defects, fail to erupt normally• Nails are dystropic and frequently missing• Lesions heal with atrophic scarring, sometimes post inflammatory hypopigmentation or depigmentation 33. • Pigmented nevi common• Alopecia affects [slideshare.net]
It is therefore an extremely useful clinical finding, although it cannot be used as a diagnostic tool until after the primary teeth have erupted. Figure 5 Rather profound enamel pitting in a patient with JEB. There are two major JEB subtypes. [ojrd.biomedcentral.com]
- Pruritic Rash
Case report A 53-year-old Singaporean Chinese first presented to the National Skin Centre, Singapore, 14 years ago with severely pruritic rashes on the lower limbs. [ijdvl.com]
Psychiatrical
- Suggestibility
A lodscore of 4.71 at e = 0 was obtained, suggesting linkage with COL7A1. Heterozygosity for a COL7A1 mutation most proba- bly causes EB in this family. [dokumen.tips]
Conclusion: These results are suggestive for an autosomal semidominant model of inheritance with incomplete penetrance and variable expression for the identified mutation. [hal.archives-ouvertes.fr]
Features were suggestive of pretibial DEB. Since it was associated with intense itching, the lesion was termed as pretibial DEB pruriginosa which has combined elements of exclusive pretibial lesions and intense itching. [ijpd.in]
Individual lesions, which tend to be papular or plaque-like, are often violaceous, suggesting the clinical diagnosis of lichen planus. Some patients complain of pruritus. [orpha.net]
Neurologic
- Irritability
Allergies, irritants, your genetic makeup, and certain diseases and immune system problems can cause rashes, hives, and other skin conditions. Many skin problems, such as acne, also affect your appearance. [icdlist.com]
Maintain a cool environment and avoid overheating Use foam padding or sheepskins to help reduce friction on pieces of furniture such as beds, chairs and infant car seats Choose clothing (including nappies) and footwear that is light, has no irritating [dermnetnz.org]
- Neglect
For patients, insult is thus added to injury and they feel abandoned, neglected, and frustrated. [books.google.de]
Urogenital
- Urinary Retention
• Blisters may occur on the cornea, resulting in pain, erosions, scarring, and, very rarely, blindness• Urethral meatal stenosis, urinary retention, hydronephrosis and bladder hypertrophy, Squamous cell carcinoma• 40% of patients die in first year, most [slideshare.net]
Urinary tract involvement in epidermolysis bullosa. Pediatrics 1973; 51 :938–941. 21 Gunduz K, Vatansever S, Turel A, Sen S. Recessive dystrophic epidermolysis bullosa complicated with nephrotic syndrome due to secondary amyloidosis. [nature.com]
- Incontinence
Pigment incontinence was noted. Histological features were suggestive of a noninflammatory subepidermal bullous disorder favoring a diagnosis of DEB. [ijpd.in]
Workup
Microbiology
- Human Papillomavirus
TR, et al.Production of human papillomavirus andmodulation of the infectious programin epithelial raft cultures. [docslide.com.br]
Other Pathologies
- Lymphocytic Infiltrate
The dermis may show moderately dense lymphocytic infiltrate. The keratinous cysts have been linked to be of eccrine origin. [10] The mainstay of treatment for this condition includes prevention of trauma and local wound care. [ijpd.in]
There was mild interstitial and perivascular polymorpho-lymphocytic infiltrate in the upper and mid-dermis. Milia were also observed in few sections. He could not afford the cost of immmunofluorescence or molecular studies. [ispub.com]
Treatment
Because skin blisters are the initial manifestation of epidermolysis bullosa (EB), patients invariably present to the dermatologist for diagnosis and treatment. [books.google.de]
Recent advances in the treatment of junctional EB by transplantation of genetically modified epidermal stem cells and successful gene expression repair by spliceosome-mediated RNA trans-splicing in EB simplex promise to revolutionize the treatment of [ijpd.in]
The demarcation of the antigens in the roof of the blister suggests cleavage below the lamina densa There are no effective treatments nor cure for EB. The treatments include multidisciplinary health care and social well-being. [ncbi.nlm.nih.gov]
Interdisciplinary management and treatment The objective of treatment of EB is a quality of life as normal as possible; causal treatment of EB including gene therapy is still not available [Ferrari et al. 2006]. [med-college.de]
The prognosis was explained to the patient and he was given symptomatic treatment. [e-ijd.org]
Prognosis
The prognosis was explained to the patient and he was given symptomatic treatment. [e-ijd.org]
Their prognosis mainly depends on adequate nutrition and hence on their dental status. Classification and pathogenesis of EB EB is classified by clinical, genetic and, above all, ultra-structural criteria. [med-college.de]
• Bistering in mouth is mild and teeth normal• Perianal lesions – intense pain• Clinically often impossible to distinguish from Dominant DEB• Good long term prognosis 50. [slideshare.net]
Prognosis varies considerably and is based on both EB subtype and the overall health of the patient. [ojrd.biomedcentral.com]
[…] fibrils. 27 DEB is characterized by abnormal fibrils and blister formation beneath the lamina densa of the dermoepidermal junction. 28 The ultrastructural findings of skin in DEB often reflect the severity of clinical disease and can be an indicator of prognosis [nature.com]
Etiology
Etiology Pretibial DEB is caused by mutations within the type VII collagen gene ( COL7A1 ). Mutations in this gene lead to an alteration of function or to reduced amounts of collagen VII. [orpha.net]
Life with Epidermolysis Bullosa (EB): Etiology, Diagnosis, Multidisciplinary Care and Therapy, New York: Springer Wien; 2009. [rarediseases.org]
( J Clin Invest 2009;119:1784 ) Junctional: blisters within lamina lucida, skin appears normal Dystrophic: blisters are sub-lamina densa; dominant or recessive Kindler syndrome: blisters at multiple levels (intra-lamina lucida and sub-lamina densa) Etiology [pathologyoutlines.com]
Life with epidermolysis bullosa (EB): etiology, diagnosis, multidisciplinary care and therapy. Wien/New York: Springer; 2008. p. 185–96. Google Scholar 37. [doi.org]
Life with epidermolysis bullosa: etiology, diagnosis, and multidisciplinary care and therapy. Wien/New York: Springer Verlag GmbH; 2009. p. 338. Google Scholar Fine JD, Eady RAJ, Bauer EA, et al. [link.springer.com]
Epidemiology
Summary Epidemiology Prevalence is unknown. Approximately 40 families or sporadic cases have been reported to date. Clinical description The disease usually manifests at birth or during infancy, but may also be delayed until the adolescence. [orpha.net]
[…] eosinophils inv(16)(p13q22) or t(16;16)(p13;q22) Synonym(s): - DEB, acral - DEB-ac Classification (Orphanet): - Rare genetic disease - Rare skin disease Classification (ICD10): - Congenital malformations, deformations and chromosomal abnormalities - Epidemiological [csbg.cnb.csic.es]
Google Scholar Fine JD: Epidemiology and the study of genetic diseases. Edited by: Grob JJ, MacKie R, Stern R, Weinstock M. Epidemiology and prevention of skin diseases London: Blackwell Science; 1996. [ojrd.biomedcentral.com]
Fine JD, Bauer E, McGuire J, Moshell A, eds.Epidermolysis Bullosa: Clinical, Epidemiologic, and Laboratory Advances and the Findings of the National Epidermolysis Bullosa Registry 1st edition The Johns Hopkins University Press; 1999. [rarediseases.org]
The epidemiology of inherited epidermolysis bullosa. Findings in US, Canadian, and European study populations. In: Fine JD, Bauer EA, McGuire J, Moshell A, editors. [nature.com]
Pathophysiology
Pathophysiology In the absence of mutations of the COL7A1 gene, an autoimmune response against type VII collagen can result in an acquired form of epidermolysis bullosa called epidermolysis bullosa acquisita. [8] There exist other types of inherited epidermolysis [ipfs.io]
Pathophysiology [ edit ] In the absence of mutations of the COL7A1 gene, an autoimmune response against type VII collagen can result in an acquired form of epidermolysis bullosa called epidermolysis bullosa acquisita. [7] There exist other types of inherited [en.wikipedia.org]
Prevention
Prevention It's not possible to prevent epidermolysis bullosa. But you can take steps to help prevent blisters and infection. Handle your child gently. Your infant or child needs cuddling, but be very gentle. [mayoclinic.org]
Your skin Holds body fluids in, preventing dehydration Keeps harmful microbes out, preventing infections Helps you feel things like heat, cold, and pain Keeps your body temperature even Makes vitamin D when the sun shines on it Anything that irritates [icdlist.com]
Therapy should be directed toward prevention of skin trauma to avoid new blister formation, prevention of secondary bacterial infection, aggressive treatment of infection when it occurs, measures to improve wound healing, maintenance of good nutrition [nature.com]
Management• Blistering becomes less frequent as age advances• Prevention of trauma• Prevention of infection• Avoidance of provocating factors• Treatment of complications• Usually a team approach 56. • Genetic councilling Gold standard is identification [slideshare.net]
When necessary, treatment with oral and topical medications may be prescribed by your doctor to assist healing or prevent complications. The following are some general measures used in caring for a patient with EB. [dermnetnz.org]