Table 1.
Incidence of symptoms in patients with RDEB
| Symptom | % | n/N | Design, country |
|---|---|---|---|
| Blisters/lesions | |||
| Blisters at or within 1 week of birth | 94 | 15/16 | Registry analysis, Australia/NZ [35] |
| 86 | 12/14 | Registry analysis, UK [33] | |
| 70 | 7/10 | Single-center, Saudi Arabia [16] | |
| Oral lesions | |||
| Any oral lesions | 100 | 35/35a | Multicenter, Spain [48] |
| 92 | 33/35b | Multicenter, Spain [48] | |
| 89 | 8/9c | Registry analysis, UK [33] | |
| 79 | 22/28 | Single-center, Japan [43] | |
| Lingual lesions | 77 | 27/35 | Multicenter, Spain [48] |
| Dental lesions | 61 | 17/28 | Single-center, Japan [43] |
| Soft palate lesions | 60 | 21/35 | Multicenter, Spain [48] |
| Oral bullae | 59 | 10/17d | Case-review, Serbia [21] |
| Lesions on lips, mouth, tongue or ear | 53 | 32/60 | Single-center, Brazil [22] |
| Hard palate lesions | 53 | 18/35 | Multicenter, Spain [48] |
| Labial lesions | 46 | 16/35 | Multicenter, Spain [48] |
| Palatal milium cysts | 46 | 16/35 | Multicenter, Spain [48] |
| Jugal mucosa | 34 | 12/35 | Multicenter, Spain [48] |
| Other lesions | |||
| Nail lesions | 75 | 21/28 | Single-center, Japan [43] |
| Lip lesions | 53 | 32/60 | Single-center, Brazil [22] |
| Esophageal lesions | 47 | 28/60 | Single-center, Brazil [22] |
| Nostril lesions | 18 | 11/60 | Single-center, Brazil [22] |
| Eyelid blisters | 7 | 5/72 | Single-center, UK [51] |
| External ear canal lesions | 3 | 2/60 | Single-center, Brazil [22] |
| Larynx lesions | 2 | 1/60 | Single-center, Brazil [22] |
| Strictures/stenoses | |||
| Esophageal strictures/stenosis | 86 | 6/7 | Single-center, US [52] |
| 81 | 43/53 | Survey, US [53] | |
| 65 | 37/57 | Single-center, UK [31] | |
| 64 | 100/157 | Single-center, Germany [55] | |
| 64 | 53/83 | Survey, International [54] | |
| 51 | 216/424 | Registry analysis, US [30] | |
| Other strictures/stenoses | |||
| Anal strictures | 15 | 62/422 | Registry analysis, US [30] |
| Pulmonary artery stenosis | 14 | 1/7 | Single-center, US [52] |
| Nostril stenoses | 5 | 3/60 | Single-center, Brazil [22] |
| Urethral meatal stenoses | 3 | 14/425 | Registry analysis, US [27] |
| Anterior commissure stenoses | 2 | 1/60 | Single-center, Brazil [22] |
| Pyloric stenoses or atresia | 1 | 5/419 | Registry analysis, US [30] |
| Laryngeal stenoses | 0.7 | 3/412 | Registry analysis, US [29] |
| Rectal strictures | 0.2 | 1/422 | Registry analysis, US [30] |
| Malnutrition/failure to thrive | |||
| Malnutrition/nutritional problems | 72 | 38/53 | Survey, US [53] |
| 50 | 12/24 | Single-center, France [20] | |
| Failure to thrive | 39 | 22/57 | Single-center, UK [31] |
| 25 | 21/83 | Survey, International [54] | |
| Growth problems diagnosed by physician | 34 | 18/53 | Survey, US [53] |
| Negative height standard deviation scores | 94 | 17/18 | Single-center, UK [44] |
| Negative height velocity standard deviation scores | 89 | 16/18 | Single-center, UK [44] |
| Nutritional deficiencies | |||
| Selenium deficiency | 94 | NR | Single-center, Germany [55] |
| Vitamin D deficiency | 67 | NR | Single-center, Germany [55] |
| Low albumin levels | 56 | NR | Single-center, Germany [55] |
| Zinc deficiency | 55 | NR | Single-center, Germany [55] |
| Anemia | |||
| Any anemia | 100 | 10/10 | Single-center, Saudi Arabia [16] |
| 91 | 143/157 | Single-center, Germany [55] | |
| 76 | 40/53 | Survey, US [53] | |
| 68 | 17/25 | Registry, Australia [34] | |
| 60 | 47/79 | Registry, UK [17] | |
| 52 | 43/83 | Survey, International [54] | |
| 50 | 3/6 | Single-center, US [52] | |
| Pseudosyndactyly | |||
| Any pseudosyndactyly | 71 | 5/7 | Single-center, Japan [43] |
| 50 | 14/28 | Single-center, US [52] | |
| 22 | 2/9 | Single-center, Saudi Arabia [16] | |
| Pseudosyndactyly of foot | 55 | 46/83 | Survey, International [54] |
| Pseudosyndactyly of hand | 65 | NR/425 | Registry, US [28] |
| 13 | 11/83 | Survey, International [54] | |
| Ocular symptoms | |||
| Any ocular symptoms | 68 | 36/53 | Survey, US [53] |
| 52 | 16/31 | NR, Chile [42] | |
| 52 | 43/83 | Survey, International [54] | |
| 51 | 37/72 | Single-center, UK [51] | |
| Corneal complications in those with ocular symptoms | 100 | 16/16 | NR, Chile [42] |
| 68 | 25/37 | Single-center, UK [51] | |
| 63 | 5/8c | Registry analysis, UK [33] | |
| Other ocular symptoms in those experiencing ocular involvement | |||
| Anterior blepharitis and collarettes | 94 | 15/16 | NR, Chile [42] |
| Corneal erosions | 63 | 5/8c | Registry analysis, UK [33] |
| Symblepharon | 59 | 8/16 | NR, Chile [42] |
| Ectropion | 38 | 6/16 | NR, Chile [42] |
| 13 | 1/8c | Registry analysis, UK [33] | |
| Conjunctival complications | 14 | 5/37 | Single-center, UK [51] |
| Exposure keratitis associated with upper and lower eyelid extropian’s | 8 | 3/37 | Single-center, UK [51] |
| Other commonly reported symptoms | |||
| Nail dystrophy and loss | 100 | 10/10 | Single-center, Saudi Arabia [16] |
| 100 | 12/12 | Registry analysis, UK [33] | |
| Milia | 100 | 9/9 | Single-center, Saudi Arabia [16] |
| 93 | 49/53 | Survey, US [53] | |
| 21 | 6/28 | Single-center, Japan [43] | |
| Constipation | 75 | 9/12 | Registry, UK [33] |
| 72 | 38/53 | Survey, US [53] | |
| 60 | 254/422 | Registry analysis, US [30] | |
| 40 | 23/57 | Single-center, UK [31] | |
| Musculoskeletal contractures | 87 | 46/53 | Survey, US [53] |
| 67 | 4/6 | Single-center, US [52] | |
| 30 | 3/10 | Single-center, Saudi Arabia [16] | |
| Dental caries | 24 | 54/225e | Case-review, Serbia [21] |
| Infections | |||
| Any infection | 64 | 53/83 | Survey, International [54] |
| Skin infection | 90 | 9/10 | Single-center, Saudi Arabia [16] |
| Recurrent respiratory infection | 50 | 5/10 | Single-center, Saudi Arabia [16] |
| Bacterial septicemia | 20 | 2/10 | Single-center, Saudi Arabia [16] |
| Candida septicemia | 10 | 1/10 | Single-center, Saudi Arabia [16] |
DEB, dystrophic epidermolysis bullosa; NR, not reported; NZ, New Zealand; RDEB, recessive dystrophic epidermolysis bullosa; UK, United Kingdom; US, United States
aFibrotic lesion
bBlister lesion
cPopulation was patients with severe RDEB
dPopulation was children with DEB (88% RDEB)
eOf 225 permanent teeth in patients with RDEB