This is one of the interesting disorders that I came across while reading about skin disorders.

This book describes Butterfly Skin Disease (Epidermolysis Bullosa), Diagnosis and Treatment and Related Diseases.

Epidermolysis bullosa is a rare chronic non-inflammatory skin disorder that is normally inherited.

It induces the skin to be incredibly thin and brittle.

People who are born with this disorder are often known as “butterfly children” since their diseased skin is as delicate as a butterfly’s wings.

Blistering of the skin often materializes in infancy in reaction to simply being held or handled.

Epidermolysis bullosa (EB) is a group of inherited diseases that are in which large blisters and erosion develop after the slightest trauma to the skin and mucous membranes.

These may arise anywhere on the body but most often appear at areas of friction and minor trauma such as the feet and hands.

In some types, blisters may also develop in internal organs, such as the esophagus, stomach and respiratory tract, without any obvious friction.

In severe forms of the disorder, epidermolysis bullosa can be life-threatening.

Most forms of epidermolysis bullosa are produced by a genetic mutation inherited from one or both parents that affects the production of the proteins in the skin.

Epidermolysis bullosa simplex 70%

Dystrophic epidermolysis bullosa 25%

Junctional Epidermolysis bullosa 5%

Kindler syndrome rare

There is another category of epidermolysis bullosa that is not produced by a genetic mutation.

Epidermolysis bullosa acquisita develops instead as an autoimmune disorder.

Fragile or butterfly skin that blisters and tears is frequent in all forms of epidermolysis bullosa

Pain and itching often appear with the blisters and tears.

Thick skin on the palms of the hands or soles of the feet

Rough or thick fingernails or toenails

Changes in skin color or tone

Scarring and tightening of the skin

Blisters inside the mouth and throat

Dental problems such as tooth decay

Difficulty swallowing (dysphagia)

Blisters around the eyes and nose

Normally epidermolysis bullosa blisters are seen at birth and during infancy.

Epidermolysis bullosa blisters may not appear until a toddler first starts to walk or when an older child starts new physical activities that trigger more friction on the soles of the feet

A visual inspection of the skin and presenting signs may also be sufficient to make a diagnosis.

In most cases a skin biopsy of a newly induced blister might be done to confirm the diagnosis.

Families with a history of epidermolysis bullosa may need prenatal genetic testing and genetic counseling

There is no cure for epidermolysis bullosa, no matter the type.

The treatment of butterfly skin disease is mainly preventive and supportive.

Wound care

Medicines to relieve pain and inflammation

Preventing new injuries

Avoiding complications

Rehabilitation therapy

Providing good nutrition

Surgeries that are occasionally used for this disorder are:

Widening the esophagus

Placing a feeding tube

Grafting skin

Restoring movement using surgical intervention to treat contractures

Surgical excision of squamous cell carcinoma

Possible future treatments

Doctors are studying new ways to treat epidermolysis bullosa:

Gene therapy, such as gel applied to wounds of people with dystrophic epidermolysis bullosa

Bone marrow (stem cell) transplantation

Protein replacement therapy

TABLE OF CONTENT

Introduction

Chapter 1 Butterfly Skin Disease (Epidermolysis Bullosa)

Chapter 2 Causes

Chapter 3 Symptoms

Chapter 4 Diagnosis

Chapter 5 Treatment

Chapter 6 Prognosis

Chapter 7 Skin Blisters

Chapter 8 Dermatitis Herpetiformis

Epilogue