Complications
By Mayo Clinic staffIn its more-severe forms, epidermolysis bullosa can have serious complications and can be fatal. Possible complications include:
- Secondary skin infection. Blistering can leave skin vulnerable to bacterial infection, particularly staph infection, and increase your chances for sepsis.
- Sepsis. Sepsis occurs when bacteria from a massive infection enter your bloodstream and spread throughout your body. Sepsis is a rapidly progressing, life-threatening condition that can cause shock and organ failure.
- Deformities. Severe forms of epidermolysis bullosa can cause fusion of fingers or toes and abnormal bending of joints (contractures), such as fingers, knees and elbows. Special bandaging wrapped between the fingers is often used to protect the fingers and prevent this complication.
- Malnutrition. If you or your child has a form of epidermolysis bullosa that causes blistering of the mouth and other mucous membranes, eating may be difficult. The resulting malnutrition can inhibit normal growth. Children with severe epidermolysis bullosa often improve with placement of a feeding tube (gastrostomy tube) so that they can receive supplemental nutrition.
- Anemia. Continuous loss of blood from open sores and possibly inability to take in adequate nutrition may contribute to iron deficiency anemia, but the true cause is unknown.
- Eye disorders. Inflammation in the mucous membrane (conjunctiva) that lines your eyelids and part of your eyeballs can lead to erosion of the transparent, dome-shaped surface of your eyes (cornea) and, sometimes, blindness.
- Skin cancer. As adolescents and adults, people with certain types of epidermolysis bullosa are at high risk of developing a type of skin cancer known as squamous cell carcinoma.
- Death. Infants who have a lethal form of junctional epidermolysis bullosa are at high risk of infections and loss of body fluids from widespread blistering. Their survival also may be threatened because of blistering of internal organs, which may hamper their ability to get enough nourishment and, sometimes, to breathe. Many of these infants die in childhood. Milder forms of epidermolysis bullosa, however, may not affect life expectancy.
- Constricted esophagus. A continuous cycle of blistering and scarring may cause narrowing in the esophagus, making it difficult to swallow. Surgical dilatation of the esophagus can relieve this and make it easier for food to travel from your mouth to your stomach.
- Hoarse voice. Blisters and scarring in the throat and esophagus may cause a hoarse voice or hoarse-sounding cry in babies.
References
- Epidermolysis bullosa. National Institute of Arthritis and Musculoskeletal and Skin Diseases. http://www.niams.nih.gov/Health_Info/Epidermolysis_Bullosa/default.asp. Accessed June 9, 2011.
- Fine JD, et al. The classification of inherited epidermolysis bullosa (EB): Report of the third international consensus meeting on diagnosis and classification of EB. Journal of the American Academy of Dermatology. 2008;58:931.
- Fine JD. Inherited epidermolysis bullosa: Recent basic and clinical advances. Current Opinion in Pediatrics. 2010;22:453.
- Habif TP. Vesicular and bullous diseases. In: Habif TP. Clinical Dermatology: A Color Guide to Diagnosis and Therapy. 5th ed. Edinburgh, U.K.; New York, N.Y.: Mosby Elsevier; 2010. http://www.mdconsult.com/books/page.do?eid=4-u1.0-B978-0-7234-3541-9..00025-0--s0780&isbn=978-0-7234-3541-9&uniqId=240601062-5#4-u1.0-B978-0-7234-3541-9..00025-0--s0780. Accessed June 8, 2011.
- About EB. Dystrophic Epidermolysis Bullosa Research Association. http://www.debra.org/abouteb. Accessed June 10, 2011.
- Progress in epidermolysis bullosa research: Toward treatment and cure. The Journal of Investigative Dermatology. 2010;130:1778.
- Healthcare problems. Dystrophic Epidermolysis Bullosa Research Association. http://www.debra.org/healthcare. Accessed June 10, 2011.
- Hand JL (expert opinion). Mayo Clinic, Rochester, Minn. June 15, 2011.


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