RESEARCH ARTICLE


An Adult Patient with a Rare Subform of Recessive Dystrophic Epidermolysis Bullosa Inversa (Gedde-Dahl)



Tina Giner1, Cristina Has2, Matthias Goebeler3, Martin Leverkus4, Eva-Bettina Brocker1, Henning Hamm
1 Department of Dermatology, University Clinics of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany
2 Department of Dermatology, University Clinics of Freiburg, Hauptstr. 7, D-79104 Freiburg, Germany
3 Department of Dermatology, University Clinics of Giessen, Gaffkystr. 14, D-35385 Giessen, Germany
4 Department of Dermatology, University Clinics of Magdeburg, Leipziger Str. 44, D-39120 Magdeburg, Germany


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Creative Commons License
© 2010 Giner et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Dermatology, University Clinics of Würzburg, Josef-Schneider-Str. 2, D-97080 Würzburg, Germany; Tel: 49-931-201-26738; Fax: 49-931-201-26462; E-mail: hamm_h@klinik.uni-wuerzburg.de


Abstract

A 53-year-old male patient was referred for evaluation of recurrent erosions of inguinal and anogenital areas, both lower legs and the oral mucosa. In addition, almost all nails and several teeth were lacking, and the residual teeth showed enamel defects. History revealed congenital absence of skin of large parts of the lower legs and widespread blistering in early childhood. Antigen mapping showed immunoreactivity against collagen XVII, laminin 332, collagen IV and collagen VII at the epidermal side of a skin split. Molecular analysis resulted in the identification of compound heterozygous mutations in exon 3 (c.425A > G) and exon 74 (p.Arg2069Cys) of the COL7A1 gene which has been reported in one family before. We conclude that our patient suffers from recessive dystrophic epidermolysis bullosa (EB) inversa, a rare subtype of dystrophic EB first described by Gedde-Dahl. Remarkable is the relatively mild course with clinical features formerly known as Bart syndrome.

Keywords: Dystrophic epidermolysis bullosa, collagen type VII.