Symptoms
By Mayo Clinic staffThe primary indication of epidermolysis bullosa is the eruption of fluid-filled blisters (bullae) on the skin, most commonly on the hands and feet in response to friction. Blisters of epidermolysis bullosa typically develop in various areas, depending on the type. In mild cases, blisters heal without scarring.
Signs and symptoms of epidermolysis bullosa may include:
- Blistering of your skin — how widespread and severe depends on the type
- Deformity or loss of fingernails and toenails
- Internal blistering, including on the throat, esophagus, upper airway, stomach, intestines and urinary tract
- Skin thickening on palms and soles of the feet (hyperkeratosis)
- Scalp blistering, scarring and hair loss (scarring alopecia)
- Thin-appearing skin (atrophic scarring)
- Tiny white skin bumps or pimples (milia)
- Dental abnormalities, such as tooth decay from poorly formed tooth enamel
- Excessive sweating
- Difficulty swallowing (dysphagia)
When to see a doctor
Contact your doctor promptly if you or your child develops blisters, particularly if there's no apparent reason for them.
In some cases of epidermolysis bullosa, blistering may not appear until a toddler first begins to walk, or until an older child begins new physical activities that trigger more intense friction on the feet.
Call your doctor immediately if you or your child experiences problems swallowing or breathing.
Also seek immediate care if you or your child has been diagnosed with epidermolysis bullosa and develops signs of an infection around an open area of skin, including:
- Redness, heat or pain
- Pus or a yellow discharge
- Crusting
- A red line or streak under the skin, spreading outward from the wound
- A wound that does not heal
- Fever or chills
Blisters can lead to infection and deformity. Your doctor can show you how to care for them properly and advise you on ways to prevent them.
- 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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