Epidermolysis bullosa dystrophica albopapuloida Q81.2

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Epidermolysis bullosa dystrophica albapapuloidea; epidermolysis bullosa dystrophica (Pasini); Epidermolysis bullosa hereditaria et albopapuloidea; Epidermolysis papulo-alboides-Pasini; Pasini-Pierini Syndrome; Pasini Syndrome

History
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Pasini

Definition
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Autosomal dominant inherited, generalized, dystrophic epidermolysis.

Etiopathogenesis
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mutation of the COL7A1 gene mapped on chromosome 3p21.3. The mutation leads to reduced or absent synthesis of collagen type VII.

Animal experiments in collagen type VII-deficient mice showed that they produce the protein cochlin in a reduced way. This in turn leads to increased bacterial colonisation of wounds.

Manifestation
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In children, usually after the age of 5.

Clinical features
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Image of the epidermolysis bullosa dystrophica dominans. Additionally perifollicular, ivory-coloured, flat to lenticular, partly confluent papules, especially in the lumbosacral region or at the acra. These are very typical for the clinical picture. Hardly any mucosa or tooth damage.

Histology
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  • Subepidermal blistering.
  • Electron microscopic: Dermolytic blistering below the lamina densa. Reduced number of normal or rudimentary anchoring fibrils.

Differential diagnosis
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External therapy
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Internal therapy
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Successes with high-dose glucocorticoid pulse therapy(100-150 mg/day prednisolone) have been described. Treatment is generally cautious, as blister formation decreases continuously and disappears within the first years of life.

Literature
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  1. Dharma B et al (2001) Dominant dystrophic epidermolysis bullosa presenting as familial nail dystrophy. Clin Exp Dermatol 26: 93-96
  2. Horn HM, Tidman MJ (2002) The clinical spectrum of dystrophic epidermolysis bullosa. Br J Dermatol 146: 267-274
  3. Jonkman MF et al (1999) Dominant dystrophic epidermolysis bullosa (Pasini) caused by a novel glycine substitution mutation in the type VII collagen gene (COL7A1). J Invest Dermatol 112: 815-817
  4. Shenefelt PD et al (1993) Successful treatment of albopapuloid epidermolysis bullosa (Pasini's variant) wirh pulse topical corticosteroid therapy. J Am Acad Dermatol 29: 785-786

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Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

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Last updated on: 29.10.2020