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Skin fusion on the fingers and toes of an adolescent girl
The Clinical Advisor, 09/10/09
Burkhart CG – A 12–year–old white girl was brought to my office by her parents. Blisters and erosions had been present on her trunk, extremities, and acral skin at birth. As she had grown, trauma–induced blistering with subsequent scarring had led to fusion of the skin of her fingers and toes. At presentation, she had no ulcerations and only minor blistering on her elbows. Previous skin biopsies had revealed a subepidermal blister. The girl was the first child of two children born to nonconsanguineous parents. There was no family history of blistering disorders or nail dystrophy...The patient has the Hallopeau–Siemens variant of dystrophic epidermolysis bullosa (EB). EB comprises a group of rare genetic states that are characterized by extremely fragile skin and recurrent blister formation following minor mechanical friction or trauma.
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