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Vol. 100. Issue 10.
Pages 842-856 (December 2009)
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Vol. 100. Issue 10.
Pages 842-856 (December 2009)
Review article
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Congenital Epidermolysis Bullosa: A Review
Epidermólisis Ampollosa Congénita : Revisión del Tema
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C. Siañez-González, R. Pezoa-Jares, J.C. Salas-Alanis
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salas999@hotmail.com
doctor@juliosalas.com

Correspondence: Otomí #206, Colonia Azteca. Cd. Guadalupe. Nuevo León, 67150 Mexico.
Escuela de Medicina del Instituto Tecnológico y de Estudios Superiores de Monterrey, Nuevo León, Mexico
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Abstract

Epidermolysis bullosa is a group of hereditary diseases affecting 1 in 17 000 live births worldwide. It consists of blistering of the skin and mucous membranes in response to minimal trauma. The disorder seriously affects the patient's quality of life. Diagnosis is based on immunofluorescence mapping and electron microscopy. Treatment is symptomatic, although new cellular and molecular therapies are currently under investigation. This review covers aspects of the molecular biology, clinical presentation, diagnosis, and treatment of epidermolysis bullosa relevant to improving the care for affected patients.

Key words:
epidermolysis bullosa
molecular biology
treatment
Resumen

La epidermólisis ampollosa (EA) engloba un grupo de enfermedades hereditarias que afectan a uno de cada 17.000 nacidos vivos en el mundo. Consiste en la formación de ampollas ante el menor traumatismo que afectan a la piel y a las mucosas. Esta enfermedad empeora seriamente la calidad de vida. El diagnóstico se realiza principalmente por mapeo por inmunofluorescencia y microscopía electrónica. El tratamiento es sintomático, aunque se están investigando nuevas terapias celulares y moleculares. Esta revisión presentará información relevante sobre la biología molecular, la sintomatología clínica, el diagnóstico y el tratamiento de la EA, con la clara intención de proporcionar un mejor cuidado a los pacientes que padecen esta enfermedad.

Palabras clave:
epidermólisis ampollosa
biología molecular
tratamiento
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References
[1.]
J. Uitto, L. Pulkkinen.
Epidermolysis bullosa in Mexico.
Int J Dermatol, 39 (2000), pp. 433-435
[2.]
J.C. Salas-Alanis, J.A. McGrath.
Las epidermólisis bullosas distróficas en México: 2470insG representa la mutación más común en 21 familias.
Gac Med Mex, 142 (2006), pp. 29-34
[3.]
C. Featherstone.
Epidermolysis bullosa: from fundamental molecular biology to clinical therapies.
J Invest Dermatol, 127 (2007), pp. 256-259
[4.]
J.C. Salas-Alanis.
Las epidermólisis bullosas. El proyecto DebRA.
Med Cutan Iber Lat Am, 35 (2007), pp. 165-166
[5.]
J.D. Fine, R.A. Eady, E.A. Bauer, J.W. Bauer, L. Bruckner-Tuderman, A. Heagerty, et al.
The classification of inherited epidermolysis bullosa (EB): Report of the Third International Consensus Meeting on Diagnosis and Classification of EB.
J Am Acad Dermatol, 58 (2008), pp. 931-950
[6.]
P. Chaudhari, M.P. Marinkovich.
What's new in blistering disorders?.
Curr Allergy Asthma Rep, 7 (2007), pp. 255-263
[7.]
Habif TP. Vesicular and bullous diseases. In: Hodgson S, Cook L, editors. Clinical Dermatology: a color guide to diagnosis and therapy. St. Louis: Mosby; 2004. (consulted: 05-09-2008). Available at: http://0-www.mdconsult.com.millenium.itesm.mx/das/book/body/109310392-2/0/1195/0.html
[8.]
W. Price-Douglas, B. Diehl-Svrjcek.
Epidermolysis bullosa: a case study in transport, treatment, and care.
Adv Neonatal Care, 7 (2007), pp. 289-294
[9.]
M. Aumailley, C. Has, L. Tunggal, L. Bruckner-Tuderman.
Molecular basis of inherited skin-blistering disorders, and therapeutic implications.
Expert Rev Mol Med, 8 (2006), pp. 1-21
[10.]
T. Masunaga.
Epidermal basement membrane: its molecular organization and blistering disorders.
Connect Tissue Res, 47 (2006), pp. 55-66
[11.]
J. Uitto, G. Richard.
Progress in epidermolysis bullosa: from eponyms to molecular genetic classification.
[12.]
H. Fassihi, T. Wong, V. Wessagowit, J.A. McGrath, J.E. Mellerio.
Target proteins in inherited and acquired blistering skin disorders.
Clin Exp Dermatol, 31 (2006), pp. 252-259
[13.]
A. Hernández-Martín.
Avances biomoleculares en los trastornos epidérmicos hereditarios.
Actas Dermosifiliogr, 96 (2005), pp. 203-216
[14.]
J.D. Conlon, B.A. Drolet.
Skin lesions in the neonate.
Pediatr Clin North Am, 51 (2004), pp. 863-888
[15.]
P.H. Schuilenga-Hut, P. Vlies, M.F. Jonkman, E. Waanders, C.H. Buys, H. Scheffer.
Mutation analysis of the entire keratin 5 and 14 genes in patients with epidermolysis bullosa simples and identification of novel mutations.
Hum Mutat, 21 (2003), pp. 447
[16.]
Y. Mitsuhashi, I. Hashimoto.
Genetic abnormalities and clinical classification of epidermolysis bullosa.
Arch Dermatol Res, 295 (2003), pp. S29-33
[17.]
J. Uitto.
Epidermolysis bullosa: the expanding mutation database.
J Invest Dermatol, 123 (2004), pp. xii-xiii
[18.]
R. Bergman.
Dermatopathology and molecular genetics.
J Am Acad Dermatol, 58 (2008), pp. 452-457
[19.]
C. Solovan, M. Ciolan, L. Olariu.
The biomolecular and ultrastructural basis of epidermolysis bullosa.
Acta Dermatovenerol Alp Panonica Adriat, 14 (2005), pp. 127-135
[20.]
E.G. Pfendner, A. Bruckner, P. Conget, J. Mellerio, F. Palisson, A.W. Lucky.
Basic science of epidermolysis bullosa and diagnostic and molecular characterization: proceedings of the 2nd International Symposium on Epidermolysis Bullosa. Santiago, Chile, 2005.
Int J Dermatol, 46 (2007), pp. 781-794
[21.]
J.C. Salas-Alanis, M. Amaya-Guerra, J.A. McGrath.
The molecular basis of dystrophic epidermolysis bullosa in Mexico.
Int J Dermatol, 39 (2000), pp. 436-442
[22.]
Marinkovich MP. Epidermolysis bullosa. eMedicine [Internet series]; 2007 (consulted on 01-09-2008). Available at: http://www.emedicine.com/derm/topic124.htm
[23.]
J.T. Trent, R.S. Kirsner.
Epidermolysis bullosa: identification and treatment.
Adv Skin Wound Care, 16 (2003), pp. 284-290
[24.]
J.D. Fine, L.B. Johnson, M. Weiner, C. Suchindran.
Causespecific risks of childhood death in inherited epidermolysis bullosa.
Pediatr, 152 (2008), pp. 276-280
[25.]
J.F. Okulicz, N.I. Kihiczak, C.K. Janniger.
Epidermolysis bullosa simplex.
Cutis, 70 (2002), pp. 19-21
[26.]
A.S. Paller.
In this issue: The complexities of epidermolysis bullosa “simplex”.
J Invest Dermatol, 122 (2004), pp. vi-vii
[27.]
K. De Kanter.
Epidermolysis bullosa simplex: localized (Weber-Cockayne type).
Dermatol Nurs, 16 (2004), pp. 525
[28.]
M.F. Jonkman, A.M. Pasmooij, S.G. Pasmans, M.P. van den Berg, H.J. Ter Horst, A. Timmer, et al.
Loss of desmoplakin tail causes lethal acantholytic epidermolysis bullosa.
Am J Hum Genet, 77 (2005), pp. 653-660
[29.]
R. Bergman, E. Sprecher.
Histopathological and ultrastructural study of ectodermal dysplasia/skin fragility syndrome.
Am J Dermatopathol, 27 (2005), pp. 333-338
[30.]
L.H. Gu, S.C. Kim, Y. Ichiki, J. Park, M. Nagai, Y. Kitajima.
A usual frameshift and delayed termination codon mutation in keratin 5 causes a novel type of epidermolysis bullosa simplex with migratory circinate erythema.
J Invest Dermatol, 121 (2003), pp. 482-485
[31.]
K. Parsapour, M.D. Reep, L. Mohammed, A. Church, T. Shwayder.
Herlitz junctional epidermolysis bullosa presenting at birth with anonychia: a case report and review of H-JEB.
Pediatr Dermatol, 18 (2001), pp. 217-222
[32.]
E.G. Yan, J.J. Paris, J. Ahluwalia, A.T. Lane, A.L. Bruckner.
Treatment decision-making for patients with the Herlitz subtype of junctional epidermolysis bullosa.
J Perinatol, 27 (2007), pp. 307-311
[33.]
C.C. Kim, M.G. Liang, E. Pfendner, V.E. Kimonis.
What syndrome is this? Laryngo-onycho-cutaneous syndrome.
Pediatr Dermatol, 24 (2007), pp. 306-308
[34.]
B.B. Das, S. Sahoo.
Dystrophic epidermolysis bullosa.
J Perinatol, 24 (2004), pp. 41-47
[35.]
C. Pourreyron, G. Cox, X. Mao, A. Volz, N. Baksh, T. Wong, et al.
Patients with recessive dystrophic epidermolysis bullosa develop squamous-cell carcinoma regardless of type VII collagen expression.
Invest Dermatol, 127 (2007), pp. 2438-2444
[36.]
S.J. White, W.H. McLean.
Kindler surprise: mutations in a novel actin-associated protein cause Kindler syndrome.
J Dermatol Sci, 38 (2005), pp. 169-175
[37.]
Pfendner EG, Lucky AW. Dystrophic epidermolysis bullosa. GeneReviews [Internet series] 2007 (consulted: 01-09-2008). Available at: http://www.ncbi.nlm.nih.gov/bookshelf/br.fcgi?book=gene∂=EAd
[38.]
K. Tamai, I. Hashimoto, K. Hanada, S. Ikeda, S. Imamura, H. Ogawa.
Japanese guidelines for diagnosis and treatment of junctional and dystrophic epidermolysis bullosa.
Arch Dermatol Res, 295 (2003), pp. S24-S28
[39.]
S.A. Vaughan Jones, J.C. Salas-Alanís, J.A. McGrath, I. Palmer, B.S. Bhogal, M.M. Black.
A retrospective analysis of tissuefixed immunoreactants from skin biopsies maintained in Michel's medium.
Dermatology, 189 (1994), pp. 131-132
[40.]
V. Wessagowit, A. Chunharas, D. Wattanasirichaigoon, J.A. McGrath.
Globalization of DNA-based prenatal diagnosis for recessive dystrophic epidermolysis bullosa.
Clin Exp Dermatol, 32 (2007), pp. 687-689
[41.]
H. Fassihi, R.A. Eady, J.E. Mellerio, G.H. Ashton, P.J. Dopping-Hepenstal, J.E. Denyer, et al.
Prenatal diagnosis for severe inherited skin disorders: 25 years’ experience.
Br J Dermatol, 154 (2006), pp. 106-113
[42.]
J.E. Mellerio, M. Weiner, J.E. Denyer, E.I. Pillay, A.W. Lucky, A. Bruckner, et al.
Medical management of epidermolysis bullosa: proceedings of the 2nd International Symposium on Epidermolysis Bullosa, Santiago, Chile, 2005.
Int J Dermatol, 46 (2007), pp. 795-800
[43.]
R.G. Azizkhan, J.E. Denyer, J.E. Mellerio, R. González, M. Bacigalupo, A. Kantor, et al.
Surgical management of epidermolysis bullosa: proceedings of the 2nd International Symposium on Epidermolysis Bullosa, Santiago, Chile, 2005.
Int J Dermatol, 46 (2007), pp. 801-808
[44.]
A.W. Lucky, E. Pfendner, E. Pillay, J. Paskel, M. Weiner, F. Palisson.
Psychosocial aspects of epidermolysis bullosa: proceedings of the 2nd International Symposium on Epidermolysis Bullosa, Santiago, Chile, 2005.
Int J Dermatol, 46 (2007), pp. 809-814
[45.]
D. Farhi.
Surgical management of epidermolysis bullosa: the importance of a multidisciplinary management.
Int J Dermatol, 46 (2007), pp. 815-816
[46.]
G. Iohom, B. Lyons.
Anaesthesia for children with epidermolysis bullosa: a review of 20 years’ experience.
Eur J Anaesthesiol, 18 (2001), pp. 745-754
[47.]
C. Schober-Flores.
Epidermolysis bullosa: the challenges of wound care.
Dermatol Nurs, 15 (2003), pp. 135-144
[48.]
M. Kömürcü, F. Bilgin, E. Kurt, A.S. Atesalp.
Major surgery and anesthetic technique in epidermolysis bullosa.
Mil Med, 169 (2004), pp. 125-127
[49.]
L. Schachner, A. Feiner, S. Camisulli.
Epidermolysis bullosa: management principles for the neonate, infant, and young child.
Dermatol Nurs, 7 (2005), pp. 56-59
[50.]
G.B. Medina Quiñónez, T. Marchini de Oliveira, L. Aires Cándido, M.A.A.M. Machado.
Conducta clínica en un caso de epidermólisis ampollosa distrófica recesiva.
Pediatr (Asunción), 30 (2003), pp. 39-43
[51.]
A. Vargas, L. Palomer, F. Palisson.
Manifestaciones orales de la epidermólisis bullosa en el niño.
Rev Chil Pediatr, 76 (2005), pp. 612-616
[52.]
J.D. Fine, L.B. Johnson, M. Weiner, C. Suchindran.
Tracheolaryngeal complications of inherited epidermolysis bullosa: cumulative experience of the national epidermolysis bullosa registry.
Laryngoscope, 117 (2007), pp. 1652-1660
[53.]
J.D. Fine, L.B. Johnson, M. Weiner, C. Suchindran.
Gastrointestinal complications of inherited epidermolysis bullosa: cumulative experience of the National Epidermolysis Bullosa Registry.
J Pediatr Gastroenterol Nutr, 46 (2008), pp. 147-158
[54.]
Y.C. Lin, B. Golianu.
Anesthesia and pain management for pediatric patients with dystrophic epidermolysis bullosa.
J Clin Anesth, 18 (2006), pp. 268-271
[55.]
A. Srinivasin, L.S. Palmer.
Genitourinary complications of epidermolysis bullosa.
Urology, 70 (2007), pp. 179.e5-179.e6
[56.]
L.A. Fordham.
Imaging of the esophagus in children.
Radiol Clin North Am, 43 (2005), pp. 283-302
[57.]
J.D. Fine, L.B. Johnson, M. Weiner, A. Stein, S. Cash, J. Deleoz, et al.
Pseudosyndactyly and musculoskeletal contractures in inherited epidermolysis bullosa: experience of the National Epidermolysis Bullosa Registry, 1986-2002.
J Hand Surg (Br), 30 (2005), pp. 14-22
[58.]
A.W. Lucky, F. Palisson, J.E. Mellerio.
The IVth International Symposium on Epidermolysis Bullosa, Santiago, Chile, 27-29 September 2007.
J Dermatol Sci, 49 (2008), pp. 178-184
[59.]
J.D. Fine, L.B. Johnson, M. Weiner, A. Stein, S. Cash, J. DeLeoz, et al.
Genitourinary complications of inherited epidermolysis bullosa: experience of the national epidermylosis bullosa registry and review of the literature.
J Urol, 172 (2004), pp. 2040-2044
[60.]
Portz M, Stroup L. U of M Sets Course For Cure of Fatal Childhood Skin Disease. University of Minnesota Academia Health Center [Internet]; 2008 (consulted: 03-09-2008). Available at: http://www.ahc.umn.edu/news/releases/EA/index.htm
[61.]
Wagner JE. Combination chemotherapy followed by donor stem cell transplant in treating young patients with epidermolysis bullosa at high risk of developing squamous cell skin cancer. ClinicalTrials.gov [Internet]; 2008 (consulted: 03-09-2008). Available at: http://clinicaltrials.gov/ct2/show/NCT00478244
[62.]
D. Sawamura, J.R. McMillan, M. Akiyama, H. Shimizu.
Epidermolysis bullosa: directions for future research and new challenges for treatment.
Arch Dermatol Res, 295 (2003), pp. S34-S42
[63.]
T. Wong, L. Gammon, L. Liu, J.E. Mellerio, P.JC. Dopping-Hepenstal, J. Pacy, et al.
Potential of fibroblast cell therapy for recessive dystrophic epidermolysis bullosa.
J Invest Dermatol, 128 (2008), pp. 2179-2189
[64.]
S. Ferrari, G. Pellegrini, F. Mavilio, M. De Luca.
Gene therapy approaches for epidermolysis bullosa.
Clin Dermatol, 23 (2005), pp. 430-436
[65.]
A.S. Lewin, P.M. Glazer, L.M. Milstone.
Gene therapy for autosomal dominant disorders of keratin.
J Investig Dermatol Symp Proc, 10 (2005), pp. 47-61
[66.]
F. Mavilio, G. Pellegrini, S. Ferrari, F. Di Nunzio, E. Di Iorio, A. Recchia, et al.
Correction of junctional epidermolysis bullosa by transplantation of genetically modified epidermal stem cells.
Nat Med, 12 (2006), pp. 1397-1402
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