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Inherited epidermolysis bullosa: new diagnostic criteria and classification.
[junctional epidermolysis bullosa]
Epidermolysis
bullosa
(
EB
)
is
a
group
of
inherited
,
mechanobullous
disorders
caused
by
mutations
in
various
structural
proteins
in
the
skin
.
There
have
been
several
advances
in
the
classification
of
EB
since
it
was
first
introduced
in
the
late
19
th
century
.
We
now
recognize
four
major
types
of
EB
,
depending
on
the
location
of
the
target
proteins
and
level
of
the
blisters
:
EB
simplex
(
epidermolytic
)
,
junctional
EB
(
lucidolytic
)
,
dystrophic
EB
(
dermolytic
)
,
and
Kindler
syndrome
(
mixed
levels
of
blistering
)
.
This
contribution
will
summarize
the
most
recent
classification
and
discuss
the
molecular
basis
,
target
genes
,
and
proteins
involved
.
We
have
also
included
new
subtypes
,
such
as
autosomal
dominant
junctional
EB
and
autosomal
recessive
EB
due
to
mutations
in
the
dystonin
(
DST
)
gene
,
which
encodes
the
epithelial
isoform
of
bullouspemphigoid
antigen
1
.
The
main
laboratory
diagnostic
techniques-immunofluorescence
mapping
,
transmission
electron
microscopy
,
and
mutation
analysis-will
also
be
discussed
.
Finally
,
the
clinical
characteristics
of
the
different
major
EB
types
and
subtypes
will
be
reviewed
.
Diseases
Validation
Diseases presenting
"transmission electron microscopy"
symptom
epidermolysis bullosa simplex
junctional epidermolysis bullosa
kindler syndrome
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