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European Journal of Pediatrics

, Volume 161, Issue 12, pp 672–679 | Cite as

Molecular diagnostics facilitate distinction between lethal and non-lethal subtypes of junctional epidermolysis bullosa: a case report and review of the literature

  • Jürgen Bauer
  • Hauke Schumann
  • Karsten Sönnichsen
  • Maren Tomaske
  • Axel Bosk
  • Leena Bruckner-Tuderman
  • Gernot Rassner
  • Claus Garbe
Original Paper

Abstract.

The term epidermolysis bullosa (EB) encompasses a heterogeneous group of genodermatoses, characterised by fragility and blistering of the skin, often associated with extracutaneous manifestations. The clinical picture comprises severe subtypes with lethal outcome in the first years of life as well as milder subtypes with localised blistering or minimal symptoms confined exclusively to nail or teeth abnormalities. We present the case of a male infant, who was born with a few bullae and rapidly developed extensive blistering of the skin. The disease was complicated by painful erosions of the oral mucosa, refused ingestion, and recurrent infections. The child died at the age of 4 months because of cardiac failure due to severe sepsis. Antigen mapping of a skin biopsy showed a split within the lamina lucida of the epidermal basement membrane zone and junctional epidermolysis bullosa (JEB) was diagnosed within the first 3 weeks of life. Markedly reduced staining for laminin 5 indicated the Herlitz type of JEB (OMIM 226700), which could be confirmed by mutation analysis in the LAMB3 gene, showing homozygous nonsense mutations. Conclusion: early antigen mapping using antibodies against the proteins affected in epidermolysis bullosa, is a useful tool providing early mutation analysis and valuable prognostic information needed for adequate therapeutic strategies. The recently published literature on current diagnostic procedures and the revised classification system for inherited epidermolysis bullosa aim towards a better understanding of the disease.

Antigen mapping Blistering Genodermatoses Inherited epidermolysis bullosa Newborn 

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Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • Jürgen Bauer
    • 1
  • Hauke Schumann
    • 2
  • Karsten Sönnichsen
    • 1
  • Maren Tomaske
    • 3
  • Axel Bosk
    • 3
  • Leena Bruckner-Tuderman
    • 2
  • Gernot Rassner
    • 1
  • Claus Garbe
    • 1
  1. 1.Department of Dermatology, Eberhard-Karls-University Tübingen, Liebermeisterstrasse 25, 72076 Tübingen, Germany
  2. 2.Department of Dermatology, Westfälische Wilhelms-University, Münster, Germany
  3. 3.Department of Paediatrics, Eberhard-Karls-University, Tübingen, Germany

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