Hereditary epidermolysis bullosa: clinical-epidemiological profile of 278 patients at a tertiary hospital in São Paulo, Brazil

• Published in: Anais brasileiros de dermatología 2024-05, Vol.99 (3), p.380-390
• Main Authors: Thien, Chan I., Bessa, Vanessa Rolim, Miotto, Isadora Zago, Samorano, Luciana Paula, Rivitti-Machado, Maria Cecília, Oliveira, Zilda Najjar Prado de
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Brazil; Brazil - epidemiology; Child; Child, Preschool; Consanguinity; DERMATOLOGY; Epidemiology; Epidermolysis bullosa; Epidermolysis Bullosa - epidemiology; Epidermolysis Bullosa - pathology; Epidermolysis bullosa dystrophica; Epidermolysis bullosa simplex; Epidermolysis bullosa, junctional; Female; Humans; Infant; Male; Middle Aged; Original; Retrospective Studies; Sex Distribution; Tertiary Care Centers - statistics & numerical data; Tertiary healthcare; Young Adult
• ISSN: 0365-0596; 1806-4841; 1806-4841
• DOI: 10.1016/j.abd.2023.06.009

Epidermolysis bullosa (EB) is a group of rare hereditary diseases, characterized by fragility of the skin and mucous membranes. Epidemiological data on EB in Brazil are scarce. To describe epidemiological aspects of patients with EB diagnosed in the Dermatology Department of a tertiary hospital, from 2000 to 2022. An observational and retrospective study was conducted through the analysis of medical records. The evaluated data included clinical form, sex, family history, consanguinity, age at diagnosis, current age, time of follow-up, comorbidities, histopathology and immunomapping, presence of EB nevi and squamous cell carcinomas (SCC), cause of and age at death. Of 309 patients with hereditary EB, 278 were included. The most common type was dystrophic EB (DEB), with 73% (28.4% dominant DEB, 31.7% recessive DEB and 12.9% pruriginous DEB). Other types were junctional EB with 9.4%, EB simplex with 16.5% and Kindler EB with 1.1%. Women accounted for 53% and men for 47% of cases. Family history was found in 35% and consanguinity in 11%. The mean age at diagnosis was 10.8 years and the current age was 26 years. The mean time of follow-up was nine years. Esophageal stenosis affected 14%, dental alterations affected 36%, malnutrition 13% and anemia 29%. During diagnostic investigation, 72.6% underwent histopathological examination and 92% underwent immunomapping. EB nevi were identified in 17%. Nine patients had SCC. Eleven patients died. Insufficient data included to medical records, loss to follow-up, and unavailability of genetic testing. In this study, dystrophic EB predominated and the need for multidisciplinary care for comorbidities and complications was highlighted.