Consensus reclassification of inherited epidermolysis bullosa and other disorders with skin fragility.


Journal

The British journal of dermatology
ISSN: 1365-2133
Titre abrégé: Br J Dermatol
Pays: England
ID NLM: 0004041

Informations de publication

Date de publication:
10 2020
Historique:
accepted: 01 02 2020
pubmed: 6 2 2020
medline: 15 5 2021
entrez: 5 2 2020
Statut: ppublish

Résumé

Several new genes and clinical subtypes have been identified since the publication in 2014 of the report of the last International Consensus Meeting on Epidermolysis Bullosa (EB). We sought to reclassify disorders with skin fragility, with a focus on EB, based on new clinical and molecular data. This was a consensus expert review. In this latest consensus report, we introduce the concept of genetic disorders with skin fragility, of which classical EB represents the prototype. Other disorders with skin fragility, where blisters are a minor part of the clinical picture or are not seen because skin cleavage is very superficial, are classified as separate categories. These include peeling skin disorders, erosive disorders, hyperkeratotic disorders, and connective tissue disorders with skin fragility. Because of the common manifestation of skin fragility, these 'EB-related' disorders should be considered under the EB umbrella in terms of medical and socioeconomic provision of care. The proposed classification scheme should be of value both to clinicians and researchers, emphasizing both clinical and genetic features of EB. What is already known about this topic? Epidermolysis bullosa (EB) is a group of genetic disorders with skin blistering. The last updated recommendations on diagnosis and classification were published in 2014. What does this study add? We introduce the concept of genetic disorders with skin fragility, of which classical EB represents the prototype. Clinical and genetic aspects, genotype-phenotype correlations, disease-modifying factors and natural history of EB are reviewed. Other disorders with skin fragility, e.g. peeling skin disorders, erosive disorders, hyperkeratotic disorders, and connective tissue disorders with skin fragility are classified as separate categories; these 'EB-related' disorders should be considered under the EB umbrella in terms of medical and socioeconomic provision of care. Linked Comment: Pope. Br J Dermatol 2020; 183:603.

Sections du résumé

BACKGROUND
Several new genes and clinical subtypes have been identified since the publication in 2014 of the report of the last International Consensus Meeting on Epidermolysis Bullosa (EB).
OBJECTIVES
We sought to reclassify disorders with skin fragility, with a focus on EB, based on new clinical and molecular data.
METHODS
This was a consensus expert review.
RESULTS
In this latest consensus report, we introduce the concept of genetic disorders with skin fragility, of which classical EB represents the prototype. Other disorders with skin fragility, where blisters are a minor part of the clinical picture or are not seen because skin cleavage is very superficial, are classified as separate categories. These include peeling skin disorders, erosive disorders, hyperkeratotic disorders, and connective tissue disorders with skin fragility. Because of the common manifestation of skin fragility, these 'EB-related' disorders should be considered under the EB umbrella in terms of medical and socioeconomic provision of care.
CONCLUSIONS
The proposed classification scheme should be of value both to clinicians and researchers, emphasizing both clinical and genetic features of EB. What is already known about this topic? Epidermolysis bullosa (EB) is a group of genetic disorders with skin blistering. The last updated recommendations on diagnosis and classification were published in 2014. What does this study add? We introduce the concept of genetic disorders with skin fragility, of which classical EB represents the prototype. Clinical and genetic aspects, genotype-phenotype correlations, disease-modifying factors and natural history of EB are reviewed. Other disorders with skin fragility, e.g. peeling skin disorders, erosive disorders, hyperkeratotic disorders, and connective tissue disorders with skin fragility are classified as separate categories; these 'EB-related' disorders should be considered under the EB umbrella in terms of medical and socioeconomic provision of care. Linked Comment: Pope. Br J Dermatol 2020; 183:603.

Identifiants

pubmed: 32017015
doi: 10.1111/bjd.18921
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

614-627

Subventions

Organisme : Debra
Pays : International

Commentaires et corrections

Type : CommentIn

Informations de copyright

© 2020 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists.

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Auteurs

C Has (C)

Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

J W Bauer (JW)

Department of Dermatology and Allergology and EB Haus Austria University Hospital of the Paracelsus Medical University Salzburg, Austria.

C Bodemer (C)

Department of Dermatology, Necker Hospital des Enfants Malades, University Paris-Centre APHP 5, Paris, France.

M C Bolling (MC)

University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.

L Bruckner-Tuderman (L)

Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.

A Diem (A)

Department of Dermatology and Allergology and EB Haus Austria University Hospital of the Paracelsus Medical University Salzburg, Austria.

J-D Fine (JD)

Vanderbilt University School of Medicine, Nashville, TN, USA; National Epidermolysis Bullosa Registry, Nashville, TN, USA.

A Heagerty (A)

Heart of England Foundation Trust, Birmingham, UK.

A Hovnanian (A)

INSERM UMR1163, Imagine Institute, Department of Genetics, Necker hospital for sick children, Paris University, Paris, France.

M P Marinkovich (MP)

Stanford University School of Medicine, Stanford, Palo Alto Veterans Affairs Medical Center CA, USA.

A E Martinez (AE)

Dermatology Department, Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK.

J A McGrath (JA)

St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK.

C Moss (C)

Birmingham Children's Hospital and University of Birmingham, UK.

D F Murrell (DF)

St George Hospital and University of New South Wales, Sydney, Australia.

F Palisson (F)

DEBRA Chile, Facultad de Medicina Clinica Alemana-Universidad del Desarrollo, Santiago, Chile.

A Schwieger-Briel (A)

Department of Pediatric Dermatology, University Children's Hospital Zürich, Zürich, Switzerland.

E Sprecher (E)

Division of Dermatology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

K Tamai (K)

Dermatology Department, University of Osaka, Osaka, Japan.

J Uitto (J)

Thomas Jefferson University, Philadelphia, PA, USA.

D T Woodley (DT)

University of Southern California, Los Angeles, CA, USA.

G Zambruno (G)

Dermatology Unit, Bambino Gesù Children's Hospital, Rome, Italy.

J E Mellerio (JE)

St John's Institute of Dermatology, King's College London and Guy's and St Thomas' NHS Foundation Trust, London, UK.

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