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Margaret I. Stewart, MD; David T. Woodley, MD; Robert A. Briggaman, MD

Arch Dermatol. 1991;127(3):373-377.

Abstract
• Epidermolysis bullosa acquisita (EBA) is a well-characterized, subepidermal blistering disorder associated with autoimmunity to type VII collagen, which is the collagen localized to anchoring fibrils within the dermoepidermal junction of skin. Although the full clinical spectrum of EBA is still being defined, it is known that the clinical features of EBA may be reminiscent of hereditary dystrophic epidermolysis bullosa, a scarring blistering disease of children that is commonly associated with esophageal stenosis. We describe a patient with EBA who had both an acral-predominant mechanobullous disease akin to dystrophic epidermolysis bullosa and an inflammatory, widespread bullous eruption reminiscent of bullous pemphigoid in association with esophageal webs and dysphagia. Although esophageal involvement is common in dystrophic epidermolysis bullosa, a review of the literature shows that this is the first bonafide case of EBA with symptomatic esophageal disease.

(Arch Dermatol. 1991;127:373-377)

Author Affiliations
From the Departments of Dermatology, Stanford (Calif) University School of Medicine (Drs Stewart and Woodley), and the University of North Carolina School of Medicine, Chapel Hill (Dr Briggaman).

Footnotes
Accepted for publication September 28, 1990.

Presented at the winter meeting of the San Francisco Dermatology Society, San Francisco, Calif, January 26, 1990.

Reprint requests to Department of Dermatology, Room R-144, Stanford University School of Medicine, Stanford, CA 94305 (Dr Woodley).

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