Clinical and molecular features in a cohort of Middle Eastern patients with epidermolysis bullosa

Pediatr Dermatol. 2023 Nov-Dec;40(6):1021-1027. doi: 10.1111/pde.15440. Epub 2023 Oct 12.

Abstract

Background: Epidermolysis bullosa (EB) features skin and mucosal fragility due to pathogenic variants in genes encoding components of the cutaneous basement membrane. Based on the level of separation within the dermal-epidermal junction, EB is sub-classified into four major types including EB simplex (EBS), junctional EB (JEB), dystrophic EB (DEB), and Kindler EB (KEB) with 16 EB-associated genes reported to date.

Methods: We ascertained a cohort of 151 EB patients of various Middle Eastern ethnic backgrounds.

Results: The cohort was comprised of EBS (64%, 97/151), DEB (21%, 31/151), JEB (12%, 18/151), and KEB (3%, 5/151). KRT14 and KRT5 variants were most common among EBS patients with 43% (42/97) and 46% (45/97) of EBS patients carrying mutations in either of these two genes, respectively. Truncal involvement was more common in KRT14-associated EBS as compared to EBS due to KRT5 mutations (p < .05). Mutations in COL17A1 and laminin 332-encoding genes were identified in 55% (10/18) and 45% (8/18) of JEB patients. Scarring alopecia, caries, and EB nevi were most common among JEB patients carrying COL17A1 mutations as compared to laminin 332-associated JEB (p < .05). Abnormal nails were evident in most DEB and JEB patients while poikiloderma was exclusively observed in KEB (p < .001).

Conclusions: EB patients of Middle Eastern origin were found to feature specific phenotype-genotype correlations of relevance to the diagnosis and genetic counseling of patients in this region.

Keywords: epidemiology; epidermolysis bullosa; genetics; genodermatoses.

MeSH terms

  • Epidermolysis Bullosa Dystrophica* / complications
  • Epidermolysis Bullosa Simplex* / complications
  • Epidermolysis Bullosa Simplex* / genetics
  • Epidermolysis Bullosa* / complications
  • Epidermolysis Bullosa, Junctional* / complications
  • Epidermolysis Bullosa, Junctional* / genetics
  • Epidermolysis Bullosa, Junctional* / pathology
  • Humans
  • Skin / pathology