Epidermolysis Bullosa

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Abstract
Epidermolysis is an uncommon skin disease, characterised by sub-epidermal bulla formation after relatively minor trauma. Radiological changes in epidermolysis bullosa are infrequently demonstrated, and under 30 such cases have been recorded. In these reported cases, most showed radiological changes involving the hands and feet whilst, in a few cases, the changes were described only in the oesophagus. In one case, reported by Meyer Alpert (1957), both lesions were demonstrated and the previous literature was then reviewed. Changes in the skin and mucous membranes in one case are also described by Korting (1957), whilst reference to the mucosal changes is also to be found in the continental literature (Schwab, 1952). This communication records a case of epidermolysis bullosa where the alimentary changes were so marked as to be the cause of the presenting symptoms. A.R., a white male, aged 24, was first referred to the Skin Department of the Royal Infirmary, Edinburgh, at the age of two weeks with blisters on the hands and feet. The diagnosis of epidermolysis bullosa dystrophica was then made and he has attended that department periodically as the disease progressed. He first complained of dysphagia in January, 1959. This became more severe and he was referred for investigation two months later. Clinical examination showed a thin young man, under weight at six stones, with vacuous expression, prognathic jaw, pigmented glazed skin of the extremities and scattered bullae on the arms. He was of subnormal intelligence.

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