Title:Epidermolysis Bullosa: Pediatric Perspectives
Volume: 18
Issue: 3
Author(s): Kam Lun Hon*, Samantha Chu and Alexander K.C. Leung
Affiliation:
- Department of Paediatrics, The Chinese University of Hong Kong, and Department of Paediatrics and Adolescent
Medicine, The Hong Kong Children’s Hospital, Kowloon, Hong Kong
Keywords:
Epidermolysis bullosa, simplex, dystrophica, junctional, prognosis, mutations.
Abstract:
Epidermolysis bullosa (EB) is a group of rare congenital genetic conditions that result in
painful blistering of the skin and mucous membranes, which occur with minor trauma or friction.
There are many types and subtypes of EB that need to be distinguished, as the management and
prognosis of each can vary significantly. We aim to perform an up-to-date literature review on congenital
EB for healthcare providers in pediatrics.
We performed a review of existing literature in the English language on EB via PubMed Clinical
Queries, using key words such as “epidermolysis bullosa”, “congenital” and “children”. We reviewed
EB based on the following subheadings: epidemiology, diagnosis, therapy, prognosis, and
clinical prediction guidelines.
EB is due to mutation in a number of genes, some types are autosomal dominant while others are
autosomal recessive. The underlying mechanism is a defect in attachment between or within the
epidermis and dermis of the skin. There are four main types: epidermolysis bullosa simplex, dystrophic
epidermolysis bullosa, junctional epidermolysis bullosa, and Kindler syndrome. The diagnosis
is suspected based on symptoms and confirmed by skin biopsy and definitive genetic testing.
The severity of EB can range from mild to fatal. Severe complications may arise in some EB types
and subtypes within the eye, ear, nose, upper airway, gastrointestinal and genitourinary tracts.
There is no cure for the condition to date. Optimal management must be multidisciplinary, and involves
wound care, pain control, controlling infections, nutritional support, and prevention and
treatment of complications.
EB presents in different forms. Treatment is supportive. The prognosis of milder forms is good.
Children severely affected with EB and their families live a misery life with impaired quality of
life. Health care workers must be aware of the suffering in these families and proactively support
them.