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Epidermolysis bullosa pruriginosa

MedGen UID:
266151
Concept ID:
C1275114
Disease or Syndrome
Synonyms: DEB, PRURIGINOSA; DYSTROPHIC EPIDERMOLYSIS BULLOSA PRURIGINOSA
SNOMED CT: Epidermolysis bullosa pruriginosa (403810008)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
Autosomal dominant inheritance
MedGen UID:
141047
Concept ID:
C0443147
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in heterozygotes. In the context of medical genetics, an autosomal dominant disorder is caused when a single copy of the mutant allele is present. Males and females are affected equally, and can both transmit the disorder with a risk of 50% for each child of inheriting the mutant allele.
 
Gene (location): COL7A1 (3p21.31)
 
Monarch Initiative: MONDO:0011398
OMIM®: 604129
Orphanet: ORPHA89843

Disease characteristics

Excerpted from the GeneReview: Dystrophic Epidermolysis Bullosa
Dystrophic epidermolysis bullosa (DEB) is a genetic skin disorder affecting skin and nails that usually presents at birth. DEB is divided into two major types depending on inheritance pattern: recessive dystrophic epidermolysis bullosa (RDEB) and dominant dystrophic epidermolysis bullosa (DDEB). Each type is further divided into multiple clinical subtypes. Absence of a known family history of DEB does not preclude the diagnosis. Clinical findings in severe generalized RDEB include skin fragility manifest by blistering with minimal trauma that heals with milia and scarring. Blistering and erosions affecting the whole body may be present in the neonatal period. Oral involvement may lead to mouth blistering, fusion of the tongue to the floor of the mouth, and progressive diminution of the size of the oral cavity. Esophageal erosions can lead to webs and strictures that can cause severe dysphagia. Consequently, malnutrition and vitamin and mineral deficiency may lead to growth restriction in young children. Corneal erosions can lead to scarring and loss of vision. Blistering of the hands and feet followed by scarring fuses the digits into "mitten" hands and feet, with contractures and pseudosyndactyly. The lifetime risk of aggressive squamous cell carcinoma is higher than 90%. In contrast, the blistering in the less severe forms of RDEB may be localized to hands, feet, knees, and elbows with or without involvement of flexural areas and the trunk, and without the mutilating scarring seen in severe generalized RDEB. In DDEB, blistering is often mild and limited to hands, feet, knees, and elbows, but nonetheless heals with scarring. Dystrophic nails, especially toenails, are common and may be the only manifestation of DDEB. [from GeneReviews]
Authors:
Ellen G Pfendner  |  Anne W Lucky   view full author information

Additional description

From OMIM
Dystrophic epidermolysis bullosa is an inherited skin fragility disorder associated with anchoring fibril abnormalities and sublamina densa blistering. EB pruriginosa is a rare distinct clinical subtype of dystrophic EB in which skin fragility, blistering, and scar formation are associated with intense pruritus, nodular prurigo-like lichenified lesions, nail dystrophy, and variable presence of albopapuloid lesions (McGrath et al., 1994; Cambiaghi et al., 1997). The onset of these clinical features may be evident in early childhood, but in some cases is delayed until the second or third decade of life. Autosomal dominant, autosomal recessive, and sporadic inheritance patterns have all been described in this disorder.  http://www.omim.org/entry/604129

Clinical features

From HPO
Nail dystrophy
MedGen UID:
66368
Concept ID:
C0221260
Disease or Syndrome
Onychodystrophy (nail dystrophy) refers to nail changes apart from changes of the color (nail dyschromia) and involves partial or complete disruption of the various keratinous layers of the nail plate.
Fragile skin
MedGen UID:
66826
Concept ID:
C0241181
Finding
Skin that splits easily with minimal injury.
Milia
MedGen UID:
87528
Concept ID:
C0345996
Anatomical Abnormality
Presence of multiple small cysts containing keratin (skin protein) and presenting as tiny pearly-white bumps just under the surface of the skin.
Nail dysplasia
MedGen UID:
331737
Concept ID:
C1834405
Congenital Abnormality
The presence of developmental dysplasia of the nail.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVEpidermolysis bullosa pruriginosa
Follow this link to review classifications for Epidermolysis bullosa pruriginosa in Orphanet.

Professional guidelines

PubMed

Wu XG, Yan S, Jiang JQ, Zhou TT, Fang X, Yang H, Bai XM, Wang H, Luo X
J Dermatol 2023 Jun;50(6):837-842. Epub 2023 Jan 24 doi: 10.1111/1346-8138.16729. PMID: 36694424
Wu PC, Dai YX, Li CL, Chen CC, Chang YT, Ma SH
J Dtsch Dermatol Ges 2023 Jan;21(1):7-17. Epub 2023 Jan 19 doi: 10.1111/ddg.14924. PMID: 36657040
Kim WB, Alavi A, Walsh S, Kim S, Pope E
Am J Clin Dermatol 2015 Apr;16(2):81-7. doi: 10.1007/s40257-015-0119-7. PMID: 25690953

Recent clinical studies

Etiology

Kwon IJ, Kim SE, Kim SC, Lee SE
J Dermatol 2024 Mar;51(3):441-447. Epub 2023 Dec 20 doi: 10.1111/1346-8138.17079. PMID: 38115742
Darbord D, Hickman G, Pironon N, Barbieux C, Bonnet-des-Claustres M, Titeux M, Miskinyte S, Cordoliani F, Vignon-Pennamen MD, Amode R, Hovnanian A, Bourrat E
J Eur Acad Dermatol Venereol 2022 Jan;36(1):133-143. Epub 2021 Oct 15 doi: 10.1111/jdv.17671. PMID: 34543471
Lapinski P, Lapiere JC, Traczyk T, Chan LS
Br J Dermatol 1998 Feb;138(2):315-20. doi: 10.1046/j.1365-2133.1998.02082.x. PMID: 9602882

Diagnosis

Wu XG, Yan S, Jiang JQ, Zhou TT, Fang X, Yang H, Bai XM, Wang H, Luo X
J Dermatol 2023 Jun;50(6):837-842. Epub 2023 Jan 24 doi: 10.1111/1346-8138.16729. PMID: 36694424
Kim WB, Alavi A, Pope E, Walsh S
Int J Low Extrem Wounds 2015 Jun;14(2):196-9. Epub 2015 Feb 17 doi: 10.1177/1534734615572469. PMID: 25694436
Kim WB, Alavi A, Walsh S, Kim S, Pope E
Am J Clin Dermatol 2015 Apr;16(2):81-7. doi: 10.1007/s40257-015-0119-7. PMID: 25690953
Ee HL, Liu L, Goh CL, McGrath JA
J Am Acad Dermatol 2007 May;56(5 Suppl):S77-81. doi: 10.1016/j.jaad.2006.10.017. PMID: 17434045
Cambiaghi S, Brusasco A, Restano L, Cavalli R, Tadini G
Dermatology 1997;195(1):65-8. doi: 10.1159/000245691. PMID: 9267744

Therapy

Yu L, Wang J, Bian L, Li Z, Li M, Li J, Zhang S
Dermatitis 2023 Jan-Feb;34(1):58-59. doi: 10.1089/DERM.0000000000000954. PMID: 36705654
Jiang X, Wang H, Lee M, Lin Z
JAMA Dermatol 2021 Oct 1;157(10):1243-1244. doi: 10.1001/jamadermatol.2021.3174. PMID: 34468689
Ferreira S, Azevedo A, Velho GC, Sanches M, Selores M
Australas J Dermatol 2020 Nov;61(4):355-357. Epub 2020 Jun 10 doi: 10.1111/ajd.13342. PMID: 32524588
Ertop P, Vural S, Gökpınar Ili E, Durmaz CD, Heper AO, McGrath JA, Ilgın RH, Boyvat A
Int J Dermatol 2020 Jul;59(7):851-855. Epub 2020 Jun 7 doi: 10.1111/ijd.14951. PMID: 32506551
Yang CS, Kim C, Antaya RJ
J Am Acad Dermatol 2015 Apr;72(4):703-11. Epub 2015 Jan 21 doi: 10.1016/j.jaad.2015.01.002. PMID: 25617013

Prognosis

Kim WB, Alavi A, Walsh S, Kim S, Pope E
Am J Clin Dermatol 2015 Apr;16(2):81-7. doi: 10.1007/s40257-015-0119-7. PMID: 25690953
Yang CS, Lu Y, Farhi A, Nelson-Williams C, Kashgarian M, Glusac EJ, Lifton RP, Antaya RJ, Choate KA
Pediatr Dermatol 2012 Nov-Dec;29(6):725-31. Epub 2012 Apr 20 doi: 10.1111/j.1525-1470.2012.01757.x. PMID: 22515571Free PMC Article
Covaciu C, Grosso F, Pisaneschi E, Zambruno G, Gregersen PA, Sommerlund M, Hertz JM, Castiglia D
Br J Dermatol 2011 Sep;165(3):678-82. Epub 2011 Jul 28 doi: 10.1111/j.1365-2133.2011.10414.x. PMID: 21574979
Ee HL, Liu L, Goh CL, McGrath JA
J Am Acad Dermatol 2007 May;56(5 Suppl):S77-81. doi: 10.1016/j.jaad.2006.10.017. PMID: 17434045

Clinical prediction guides

He Z, Dong Q, Xi Y, Zheng R
Medicine (Baltimore) 2024 Jul 5;103(27):e38854. doi: 10.1097/MD.0000000000038854. PMID: 38968458Free PMC Article
Kwon IJ, Kim SE, Kim SC, Lee SE
J Dermatol 2024 Mar;51(3):441-447. Epub 2023 Dec 20 doi: 10.1111/1346-8138.17079. PMID: 38115742
Yang CS, Kim C, Antaya RJ
J Am Acad Dermatol 2015 Apr;72(4):703-11. Epub 2015 Jan 21 doi: 10.1016/j.jaad.2015.01.002. PMID: 25617013
Tey HL, Lee AD, Almaani N, McGrath JA, Mills KC, Yosipovitch G
Arch Dermatol 2011 Aug;147(8):956-60. doi: 10.1001/archdermatol.2011.189. PMID: 21844455
Ee HL, Liu L, Goh CL, McGrath JA
J Am Acad Dermatol 2007 May;56(5 Suppl):S77-81. doi: 10.1016/j.jaad.2006.10.017. PMID: 17434045

Recent systematic reviews

Wu PC, Dai YX, Li CL, Chen CC, Chang YT, Ma SH
J Dtsch Dermatol Ges 2023 Jan;21(1):7-17. Epub 2023 Jan 19 doi: 10.1111/ddg.14924. PMID: 36657040
Kim WB, Alavi A, Walsh S, Kim S, Pope E
Am J Clin Dermatol 2015 Apr;16(2):81-7. doi: 10.1007/s40257-015-0119-7. PMID: 25690953

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