Abstract
AIMS—To describe the ophthalmic findings in a large cohort of epidermolysis bullosa (EB) patients managed in one large specialist centre. METHODS—A case note review of consecutive patients seen at Great Ormond Street Children's Hospital. Data on the dermatological disease, ophthalmic history, and examination were collected and coded onto a data sheet. RESULTS—181 patients: 50 (28%) simplex EB; 15 (8%) junctional EB; 28 (15%) autosomal dominant dystrophic EB; 72 (40%) autosomal recessive dystrophic EB; nine patients (5%) with dystrophic EB whose inheritance could not be ascertained; and seven cases (4%) of EB that could not be classified. Ocular problems were found in 12% (n=6) of simplex patients and 40% (n=6) of those with junctional disease. One patient (of 28) in the autosomal dominant dystrophic group had ocular involvement and 51% (37/72) of patients in the autosomal recessive dystrophic group had ophthalmic complications: corneal (25/72), lid ectropions (3/72), lid blisters (5/72), and symblepharon (3/72). CONCLUSION—Ophthalmic complications are common in EB overall but the incidence varies widely with subtype. Ophthalmic complications are the most severe in the dystrophic recessive and junctional subtypes where there is a need for extra vigilance. The major treatment modality was use of ocular lubricants. Keywords: epidermolysis bullosa
Full Text
The Full Text of this article is available as a PDF (69.8 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Christiano A. M., Uitto J. Molecular complexity of the cutaneous basement membrane zone. Revelations from the paradigms of epidermolysis bullosa. Exp Dermatol. 1996 Feb;5(1):1–11. doi: 10.1111/j.1600-0625.1996.tb00086.x. [DOI] [PubMed] [Google Scholar]
- Destro M., Wallow I. H., Brightbill F. S. Recessive dystrophic epidermolysis bullosa. Arch Ophthalmol. 1987 Sep;105(9):1248–1252. doi: 10.1001/archopht.1987.01060090106038. [DOI] [PubMed] [Google Scholar]
- Fourel E., Claudy A. L. Carcinome spino-cellulaire et épidermolyse bulleuse récessive dystrophique. Ann Dermatol Venereol. 1992;119(8):563–565. [PubMed] [Google Scholar]
- Gedde-Dahl T., Jr, Dupuy B. M., Jonassen R., Winberg J. O., Anton-Lamprecht I., Olaisen B. Junctional epidermolysis bullosa inversa (locus EBR2A) assigned to 1q31 by linkage and association to LAMC1. Hum Mol Genet. 1994 Aug;3(8):1387–1391. doi: 10.1093/hmg/3.8.1387. [DOI] [PubMed] [Google Scholar]
- Hachisuka H., Morita M., Karashima T., Sasai Y. Keratin 14 gene point mutation in the Köbner and Dowling-Meara types of epidermolysis bullosa simplex as detected by the PASA method. Arch Dermatol Res. 1995;287(2):142–145. doi: 10.1007/BF01262322. [DOI] [PubMed] [Google Scholar]
- Hovnanian A., de Prost Y. Epidermolyses bulleuses héréditaires: vers une classification et un conseil génétique basés sur l'identification des défauts moléculaires. Arch Pediatr. 1994 Nov;1(11):1028–1033. [PubMed] [Google Scholar]
- Irvine A. D., Corden L. D., Swensson O., Swensson B., Moore J. E., Frazer D. G., Smith F. J., Knowlton R. G., Christophers E., Rochels R. Mutations in cornea-specific keratin K3 or K12 genes cause Meesmann's corneal dystrophy. Nat Genet. 1997 Jun;16(2):184–187. doi: 10.1038/ng0697-184. [DOI] [PubMed] [Google Scholar]
- Lin A. N., Murphy F., Brodie S. E., Carter D. M. Review of ophthalmic findings in 204 patients with epidermolysis bullosa. Am J Ophthalmol. 1994 Sep 15;118(3):384–390. doi: 10.1016/s0002-9394(14)72964-2. [DOI] [PubMed] [Google Scholar]
- McDonnell P. J., Spalton D. J. The ocular signs and complications of epidermolysis bullosa. J R Soc Med. 1988 Oct;81(10):576–578. doi: 10.1177/014107688808101008. [DOI] [PMC free article] [PubMed] [Google Scholar]
- McGrath J. A., Gatalica B., Christiano A. M., Li K., Owaribe K., McMillan J. R., Eady R. A., Uitto J. Mutations in the 180-kD bullous pemphigoid antigen (BPAG2), a hemidesmosomal transmembrane collagen (COL17A1), in generalized atrophic benign epidermolysis bullosa. Nat Genet. 1995 Sep;11(1):83–86. doi: 10.1038/ng0995-83. [DOI] [PubMed] [Google Scholar]
- McKenna K. E., Hughes A. E., Bingham E. A., Nevin N. C. Linkage of epidermolysis bullosa simplex to keratin gene loci. J Med Genet. 1992 Aug;29(8):568–570. doi: 10.1136/jmg.29.8.568. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Phillips R. J., Aplin J. D., Lake B. D. Antigenic expression of integrin alpha 6 beta 4 in junctional epidermolysis bullosa. Histopathology. 1994 Jun;24(6):571–576. doi: 10.1111/j.1365-2559.1994.tb00578.x. [DOI] [PubMed] [Google Scholar]
- Pulkkinen L., Gerecke D. R., Christiano A. M., Wagman D. W., Burgeson R. E., Uitto J. Cloning of the beta 3 chain gene (LAMB3) of human laminin 5, a candidate gene in junctional epidermolysis bullosa. Genomics. 1995 Jan 1;25(1):192–198. doi: 10.1016/0888-7543(95)80125-6. [DOI] [PubMed] [Google Scholar]
- Sharkey J. A., Kervick G. N., Jackson A. J., Johnston P. B. Cornea plana and sclerocornea in association with recessive epidermolysis bullosa dystrophica. Case report. Cornea. 1992 Jan;11(1):83–85. doi: 10.1097/00003226-199201000-00013. [DOI] [PubMed] [Google Scholar]
- Simons K., Stein L., Sener E. C., Vitale S., Guyton D. L. Full-time atropine, intermittent atropine, and optical penalization and binocular outcome in treatment of strabismic amblyopia. Ophthalmology. 1997 Dec;104(12):2143–2155. doi: 10.1016/s0161-6420(97)30048-7. [DOI] [PubMed] [Google Scholar]
- Slater S. D., McGrath J. A., Hobbs C., Eady R. A., McKee P. H. Expression of mutant p53 gene in squamous carcinoma arising in patients with recessive dystrophic epidermolysis bullosa. Histopathology. 1992 Mar;20(3):237–241. doi: 10.1111/j.1365-2559.1992.tb00962.x. [DOI] [PubMed] [Google Scholar]
- Uitto J., Christiano A. M. Molecular basis for the dystrophic forms of epidermolysis bullosa: mutations in the type VII collagen gene. Arch Dermatol Res. 1994;287(1):16–22. doi: 10.1007/BF00370713. [DOI] [PubMed] [Google Scholar]
- Vailly J., Pulkkinen L., Christiano A. M., Tryggvason K., Uitto J., Ortonne J. P., Meneguzzi G. Identification of a homozygous exon-skipping mutation in the LAMC2 gene in a patient with Herlitz's junctional epidermolysis bullosa. J Invest Dermatol. 1995 Mar;104(3):434–437. doi: 10.1111/1523-1747.ep12666027. [DOI] [PubMed] [Google Scholar]
- Vidal F., Aberdam D., Miquel C., Christiano A. M., Pulkkinen L., Uitto J., Ortonne J. P., Meneguzzi G. Integrin beta 4 mutations associated with junctional epidermolysis bullosa with pyloric atresia. Nat Genet. 1995 Jun;10(2):229–234. doi: 10.1038/ng0695-229. [DOI] [PubMed] [Google Scholar]
