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Epidermolysis Bullosa Congenita in Twins. Myasthenia Gravis in One. Presented by Dr. Samuel M. Peck.
A boy and a girl, 9 years old, have had a bullous eruption since birth. Myasthenia gravis was noted in the girl in infancy. The parents are first cousins. The first pregnancy resulted in a miscarriage. The mother had hypertension and renal impairment during another pregnancy which resulted in the birth of a boy, now 18 years old, who suffers from myasthenia gravis. While pregnant with the twins, the mother again suffered from the same complications. They were delivered six weeks prematurely by Caesarean section. The mother's sister has one son who also has myasthenia gravis. The grandparents had diabetes. There are no other known cases of epidermolysis bullosa or myasthenia gravis in the family.
Both children show active lesions of epidermolysis bullosa, as well as scarring and nail changes. There are areas of permanent