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September 1995

Ulcers in Pretibial Epidermolysis Bullosa: Grafting With Autologous Meshed Split-Thickness Skin and Allogeneic Cultured Keratinocytes

Author Affiliations

University Hospital, Gent, Belgium

Arch Dermatol. 1995;131(9):990-992. doi:10.1001/archderm.1995.01690210020003

REPORT OF A CASE  In 1973, a 52-year-old woman presented with numerous lichenoid plaques and papules and a few flaccid bullae on both knees and the pretibial zones (Figure 1). A few isolated papules were also seen. All toenails were dystrophic. The patient suffered from extreme pruritus. While erythematous plaques were present on her knees since the age of 11 years, the clinical picture became dramatically more severe after the patient reached the age of 50.1 The patient denied the presence of similar lesions in family members.In 1989, the clinical picture became dominated by the presence of multiple ulcers of various sizes on the pretibial areas (Figure 2). The ulcers were surrounded by a fragile, poikilodermatous skin. During hospitalization, bullae appeared after minor trauma. These nonhealing bullae continuously resulted in multiple ulcers.Histologic analysis of a fresh blister by light and electron microscopy and immunohistologic studies with bullous

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