A Case for Diagnosis (Epidermolysis Bullosa Hereditaria? Porphyria Cutanea Tarda?). Presented by Dr. G. Robert Baler.
A 21-year-old American woman, employed as a secretary, is presented from Boston City Hospital. Two years ago she noted asymptomatic blisters on the second fingers of both hands, which spread to the dorsum of the hands and arms within a few days. The lesions healed with scarring in 2-3 weeks. Two months after onset the patient found that she could easily pick off the upper layers of the skin with her fingernails in all involved areas. Usually only a few blisters were present, and occasionally there was complete clearing. Increased cigarette smoking seemed to stimulate the formation of vesicles. There are no systemic symptoms.The patient tans on exposure to sunlight. In the past 2 weeks she has lost the ability to pick off the skin easily. An elder sister had a similar condition
Catinella P, Tilley RF. NEW ENGLAND DERMATOLOGICAL SOCIETY. Arch Dermatol. 1961;84(1):155–163. doi:10.1001/archderm.1961.01580130161032
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