The clinical spectrum of epidermolysis bullosa simplex

As part of the U.K. National Epidermolysis Bullosa Register, we have systematically recorded clinical information on 130 (77%) of the 168 known Scottish epidermolysis bullosa simplex (EBS) sufferers. Three subtypes of EBS were recognized: Dowling–Meara (EBS‐DM), Weber–Cockayne (EBS‐WC) and Köbner (EBS‐Kb), seen in 5%, 42% and 53% of patients, respectively. As there is considerable overlap between EBS‐WC and EBS‐Kb, with both phenotypes frequently seen within the same pedigree, EBS‐WC is best regarded as a milder variant of EBS‐Kb rather than a separate disorder. Improvement with age is common in all variants of EBS, but is not invariable. Pain due to acral blistering in EBS‐Kb/EBS‐WC has a more marked impact on life‐style than the blisters of EBS‐DM. Oral blistering, nail involvement and aplasia cutis congenita occur in all EBS subtypes and laryngeal involvement is a feature of EBS‐DM. Seasonal variation is not seen in EBS‐DM but is common in EBS‐Kb/EBS‐WC.