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As a result of this, certain key structural proteins of zantac online, dermis or basement membrane are destroyed, which disrupts the communication between cells and leads to the formation of blisters with even a slight mechanical impact. The types of epidermolysis bullosa differ from one another in the localization of the vesicles, the type of mutation that led to this disease, and the type of protein that was attacked by enzymes.
The problem is further complicated by the fact that for almost a century and a half of studying this pathology, repeated attempts have been made to divide it into certain types, using the most up-to-date data at that time. Ultimately, this led to some confusion, even in the scientific literature you can find a wide variety of options for dividing epidermolysis bullosa into varieties. The most modern classification of this condition in dermatology includes four types of the disease, which, in turn, are divided into a number of subtypes:
But even within the same type, there is a wide variety of clinical symptoms of the disease, which complicates the diagnosis and often affects the prognosis of the pathology. Therefore, today the search for a more structured and acceptable classification of epidermolysis bullosa does not stop.
Symptoms of epidermolysis bullosa. The manifestations of epidermolysis bullosa of different types are united by one thing - the development of blisters and erosions in response to a mechanical effect on the skin. Only the severity of these changes, localization, time of existence and healing results differ. With a localized form of simple epidermolysis bullosa (Weber-Cockane subtype), lesions are located only on a certain area of zantac pills.
In infancy, a wider area of the appearance of blisters is possible, but with age their severity decreases. In contrast, the generalized Dowling-Meara subtype is characterized by the development of small vesicular lesions over a large area of the body. This type of bullous epidermolysis occurs from early childhood and can cause the death of a child, the result of the resolution of the vesicles can be hyperkeratosis, skin pigmentation disorders, and sometimes mucous membranes are affected.
In this case, there is an increased fragility of the skin, the formation of a large number of bubbles, erosion, symmetrical granulations often appear on the face and back. The mucous membranes of the mouth are also affected, enamel hypoplasia and the resulting severe caries are found. Such a severe course of borderline bullous epidermolysis often causes death in the first years of life. In surviving patients in adulthood, joint contractures, kidney damage, and loss of nails are formed. A milder atrophic form of borderline epidermolysis bullosa is also characterized by extensive rashes, after resolution of which atrophic areas and scars form. It also often leads to nail dystrophy and scarring alopecia.
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Dystrophic epidermolysis bullosa is almost always generalized and affects large areas of the body. The dominant variant of the disease is generally more benign, with slow blister formation and resolution, but most patients eventually lose their fingernails. After healing of erosions, visible scars form on the surface of the skin. The recessive variant of dystrophic epidermolysis bullosa, especially its severe generalized subtype, is much more severe: in addition to rashes, patients often have pseudosyndactylia, extensive scars, and loss of nails.
There is damage to the bones of the skeleton, in place of healed scars over the years, squamous cell carcinoma can develop. The problem is also the high resistance of the Allopo-Siemens subtype to therapeutic measures. Complications of any type of epidermolysis bullosa are reduced to the risk of developing shock (with extensive lesions), the addition of a secondary infection and the sepsis provoked by it, and dehydration of patients. In most cases, therapeutic procedures are performed only to prevent these conditions. The probability of developing complications is higher, the larger the area of the body is occupied by pathological foci and the more destructive their nature (tense blisters, erosions, ulcers).
Currently, the diagnosis of epidermolysis bullosa is carried out by examining the patient's skin, using immunohistological studies and genetic analyzes, in some cases, studying the hereditary history. When examining the skin, a specialist can also perform diagnostic tests - mechanically act on the patient's skin and evaluate the results after a while. The development of blisters or erosions characteristic of epidermolysis bullosa in this area speaks in favor of the presence of this disease. At the next stages of diagnosis, a more accurate determination of the form of pathology is made.
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